# Post Proceedings of the Interacting with Assistive Technology (IATech) Workshop

Paul Whittington, Huseyin Dogan, Nan Jiang, Ruijie Wang, Chris Porter

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Paul Whittington, Huseyin Dogan, Nan Jiang, Ruijie Wang, Chris Porter. Post Proceedings of the Interacting with Assistive Technology (IATech) Workshop. 19th IFIP Conference on Human-Computer Interaction (INTERACT), Aug 2023, York, United Kingdom. pp.249-256, 10.1007/978-3-031-61698-3_24. hal-05305329

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# Post Proceedings of the Interacting with Assistive Technology (IATech) Workshop

Paul Whittington¹(✉) ID, Huseyin Dogan¹ ID, Nan Jiang¹ ID, Ruijie Wang¹ ID, and Chris Porter² ID

¹ Bournemouth University, Poole BH12 5BB, UK
{whittingtonp, hdogan, njiang}@bournemouth.ac.uk
² University of Malta, Msida MSD 2080, Malta
chris.porter@um.edu.mt

**Abstract.** Assistive Technology (ATech) is designed to increase, maintain or improve the functioning of people with disabilities. These products can consider hardware, software or mechanical devices, such as a wheelchair. People with disabilities can have varying levels of ability, and there cannot be a single solution to suit everyone. Therefore, a range of ATech products are developed to ensure that this user community is not marginalized and can interact in an inclusive society. One of the challenges of ATech is related to awareness and for people with disabilities to know about available products or services. The Interacting with Assistive Technology (IATech) Workshop at INTERACT 2023, followed the Diversity, Accessibility and Inclusivity workshops (DAI) held at BCS HCI 2021 and 2022, investigated the current approaches of developing ATech, including the challenges and lessons learned. The workshop also explored developments aiming to ensure interactive solutions are accessible and inclusive to all users. The IATech Workshop is a forum for researchers in the domains of accessibility, assistive technology, human-computer interaction and human-centered design to discuss the challenges and solutions for interacting with ATech. The Workshop concluded with a panel discussion focusing on awareness and training in ATech. The findings from the panel were used to generate a roadmap of future research directions.

**Keywords:** Accessibility · Assistive Technology · Motivational Modeling · Smart Homes · Universal Design · User Experience · Web Accessibility

## 1 Motivation

The Interacting with Assistive Technology (IATech) Workshop followed the 1st and 2nd Workshops on Diversity, Accessibility and Inclusivity (DAI) held at British HCI Conference 2021 and 2022. The DAI workshops resulted in informative discussions around the research themes, to determine a roadmap for ensuring inclusive cyber security. This is an important area of research as worldwide there are 1 billion people with disabilities, which account for 15% of the worldwide population [1].
The Organizing Committee of the IATech Workshop included Dr Dogan and Dr Whittington, who are academic representatives for the Smart Homes and Independent Living Commission that provides recommendations to the United Kingdom Government in relation to supporting the adoption of smart home technology in social care.

The worldwide standard for measuring health and disability is the International Classification for Disability, Functioning and Health (ICF) Framework, developed by the World Health Organization [2]. The aim of the ICF is to define disability as “a complex interaction between the person and their environment” instead of characterizing individuals [3]. It is therefore important to promote assistive technology (referred to as ATech) to improve quality of life and ensure there are equal opportunities for user communities to access technologies; hence this is a continuously evolving market [4]. ATech can be defined as products to “increase, maintain, or improve the functional capabilities of persons with disabilities” [5]. People with disabilities often require more advanced interaction mediums instead of traditional touch-based interaction. Sip-and-Puff is a technology that sends signals to a device using air pressure by sucking in (sipping) or blowing out (puffing) on a straw or tube and is people who have insufficient finger dexterity to operate a joystick [6]. Head-mounted displays can also be utilized as ATech.

A common challenge with ATech is awareness and for people with disabilities to know about products that are available to provide support. Whittington and Dogan [7], Organizing Committee members, developed the SmartAbility Framework and application as a solution to recommend ATech based on physical abilities, that is, the actions that the person can perform. This challenge has been acknowledged by Policy Connect who operate the All-Party Parliamentary Group for Assistive Technology, through their events held in the United Kingdom Parliament.

People with disabilities can also experience difficulties with authenticating themselves online and this is recognized by Success Criterion 3.3.7 of the Web Content Accessibility Guidelines (WCAG) 2.2 [8]. One example is users who have learning disabilities being unable to complete cognitive function tests, such as the Completely Automated Public Turing tests to tell Computers and Humans Apart (CAPTCHA). This can result in them being prevented from purchasing goods or accessing services. The World Wide Web Consortium (W3C) [8] recommends accessible authentication to promote the inclusivity of technologies to users of all abilities. Alternative verification mechanisms should be provided, including at least one that does not contain a cognitive function test.

Throughout the recent COVID-19 pandemic, there has been a growing reliance upon ATech as this provides greater independence for people with disabilities. The utilization of such technologies can help to reduce inequalities and marginalization within this community and address the intersectional divide with able-bodied users [9]. Promoting inclusive learning and teaching environments is a worldwide effort aimed at enhancing educational quality and equity for people with special needs, such as those with dyslexia. ATech for learning, including hardware devices and software plugins, offers support for reading, speech, writing, mathematics, organization and self-management [10]. However, the availability, high cost and training needs are all barriers that prevent their adoption and use by learners with difficulties or disabilities [11]. Further,
when compared to having tutors in the classroom, ATech and e-learning applications often lack context-dependent feedback, such as the encouragement needed for exploring ideas and problem-solving. Recently, systems have been increasingly ubiquitous, accessible and necessary, with the possibility to provide personalized assistance for all learners. This is also known as intelligent tutoring systems offering automated personalized guidance or services tailored to an individual user's cognitive or emotional states, with the aim of enhancing the learning experience [12]. Motivation, essential to learning success [13], is a multi-dimensional concept that influences learners' sustained intention to use an e-learning system. To identify motivational states and implement corresponding strategies during users' interactions with e-learning systems, Wang et al. [12] established an explanatory framework that modelled motivational factors, reflecting different dimensions of users' motivational needs in the context of e-learning systems. The factors included physiological data from eye tracking and EEG to create an automatic assessment [14] and an eye tracking prototype for automatic motivation assessment and personalized motivational strategies in real-time [15].

The IATech Workshop examined current approaches along with lessons learned when developing ATech. It follows the organisation of workshops on Human Centered Design for Intelligent Environments (HCD4IE) at British HCI 2016 and 2018, as well as the Diversity, Inclusivity and Accessibility of Cyber Security at BCS HCI 2021 and 2022. Bournemouth University has also held two Assistive Technology Symposia in 2018 and 2019, as well as the BU-Dundee ATech Conference in September 2023, in collaboration with the University of Dundee and Policy Connect. The audience for this Workshop was academics who have contributed to the development of ATech. This included software developers, user experience researchers, social scientists, psychologists and policymakers.

## 2 Submissions

There were five paper submissions to the IATech Workshop, which focused on the domains of ATech, humanoid robots and inclusive e-learning. Elsheikh et al. [16] presented a systematic literature review of humanoid robots in terms of their acceptance and adoption amongst adults. This explored the barriers and benefits, including influential factors such as familiarity and trust. The review highlighted the benefits of humanoid robots in terms of improving social interaction and assistance. The ethical considerations relating to privacy and data security were addressed, where it was recommended that robust privacy protocols, secure data storage and consent mechanisms should be implemented. Whittington et al. [17] discussed the EduAbility Android application that provides assistive technology recommendations and training. The application is a ability-based and condition-based recommendation system, as well as a training package for ATech, which includes multiple-choice quizzes, videos and articles. EduAbility is anticipated to improve awareness of ATech and increase potential adoption by people with disabilities. Bhatnagar et al. [18] introduced an ATech Innovator's Map, a platform to showcase ATech start-ups worldwide. The authors noted the existing gap in ATech awareness and the map provided a categorized database of start-ups from different regions, offering details such as start-up name, website, founding year, venture type, region,
country, funder, disability type and start-up stage. The Map can potentially increase vis-
ibility for start-ups, foster collaboration and serve as a resource for research and learning.
The authors also discussed challenges related to accessibility and maintenance. Pocock
et al. [19] presented a case study involving the co-production of a custom ATech with
an individual living with dystonia (referred to as Martha). Due to frequent involuntary
muscle contractions, Martha (and her occupational therapists) found it challenging to
adopt off-the-shelf ATech solution that could fully support her in her day-to-day activ-
ities. This primarily in-situ study, spanning a five month period, aimed to create an AT
that could offer Martha increased interaction independence and efficiency, while replac-
ing her current position-dependent switch-based system. Using Inertial Measurement
Unit (IMU) devices and gesture detection algorithms, they co-produced a gesture-based
ATech involving the participant and her immediate support network throughout the entire
process. In the summative evaluation stage, Martha showed increased performance and
confidence over time, although timing-related errors extended the task completion times.
The paper demonstrated the potential of machine learning and wearables for ATech
while also noting the challenges ATech users experience when transitioning to new
technologies. The authors also emphasised the importance of direct user involvement in
the development of ATech. Wang and Hook [20] investigated the connection between
dyslexic characteristics and motivational factors in e-learning environments. Based on
their previous motivational model integrating various perspectives and empirical data
[12], the results revealed significant negative correlations between dyslexic characteris-
tics and seven motivational factors, with “perceived ease of use” playing a prominent
role in affecting dyslexic learners’ motivation. The paper highlighted the importance of
exploring the impact of dyslexic characteristics on motivation and addressing the moti-
vational needs with personalised strategies in e-learning systems to improve inclusivity
for all learners.

3 Workshop Outcomes

The IATech Workshop investigated the current development of ATech, which became
a forum for researchers and academics to discuss the challenges within the assistive
technology domain. The findings from the Workshop Panel were used to create a roadmap
for promoting suitable ATech to people with disabilities, to ensure inclusive access.
This would help to provide recommendations for the ATech domain in developing new
assistive technologies. The motivation behind the IATech Workshop was to improve
the quality of life for people with disabilities through the awareness and utilisation of
suitable assistive technologies.

4 Panel Discussion

The final session in the IATech Workshop was a 30-min panel discussion with the
delegates who focused on six trigger questions:

1. What are the common challenges with ATech?

2. Are you aware of any solutions that currently raise awareness of ATech?
3. What are the lessons learnt from developing ATech?

4. Has anyone had past experience of conducting trials/evaluations of ATech?

5. What would be the recommendations for the ATech domain?

6. What would be the aspects of a roadmap to promote suitable ATech to people with disabilities?

The discussion of the first question highlighted that the main challenge was to obtain grants and funding for either the purchase or research of ATech. There can also be a challenge in school environments where there is often insufficient funding available to purchase new ATech products. Funding for ATech training was another area discussed, as it is important to ensure that teachers, support staff, parents and carers have up-to-date knowledge of ATech and the different products that can benefit people with disabilities. The cost of the products can also be a barrier to the utilization of ATech, as new products can be unaffordable to the user community. It is, therefore, important to investigate and develop low-cost solutions to maximize potential uptake of ATech. It was emphasized that co-design and co-production should be implemented through the development of ATech products, to ensure they are suitable for the intended user community. The delegates suggested that there should be stronger international networks to support the research and development of ATech. It was acknowledged that research projects in this domain can have longer durations, therefore requiring increased resources.

Existing solutions that raise awareness of ATech was the focus of the second trigger question. The delegates recommended that there should be an accurate system to support the purchase of suitable ATech products. The Global Disability Innovation Hub through their AT2030 Programme [21] and Whittington et al. [17] are conducting research into improving access to ATech. In the UK, the Government has policies supporting ATech, such as Policy Connect. However, additional support is also required to raise awareness further.

The domain knowledge of the delegates was utilized for the third trigger question into the lessons learnt from developing ATech. It was highlighted that integration of ATech into existing systems can be challenging due to compatibility issues and the need to train people to use state-of-the-art ATech products. Users can also be resistant to using new products, as they often prefer to continue with more familiar technologies.

Most of the panel delegates have had past experience of conducting evaluations of ATech through the application of existing usability tools, such as System Usability Scale (SUS) [22]. The discussion of the fourth trigger question focused on SUS not being specific to ATech, as the 10-item questionnaire as the metrics do not adequately capture accessibility-related aspects. Additional the tools themselves are not fully accessible. It was suggested that there is a gap in research to simplify usability evaluations involving people with disabilities. A more tailored SUS questionnaire for this user group was recommended through additional engagement with the user community.

The panel also discussed recommendations for the ATech domain. It was highlighted that user involvement is a key aspect of developing suitable technologies, which includes the end users, parents/carers and healthcare professionals, such as Occupational Therapists. It is also essential to include these groups of users in the requirement elicitation phase of the development, to ensure that the stakeholder requirements are captured.
There are currently no specific requirements specification templates for ATech and this could be a direction for future research.

The final section of the panel discussed the aspects of a roadmap to promote suitable ATech for people with disabilities. This combined all the areas discussed in the previous trigger questions, to improve the awareness of ATech products. The importance of normalizing ATech is essential to ensure inclusivity for all, as well as increasing the awareness of ATech products. It was suggested there should be a central database of ATech products, which is maintained and kept up to date. In the wider domain, there should be multi-disciplinary collaborations between academia, funding bodies and ATech developers. The Panelists recommended that there should be both short and long-term strategies for promoting awareness and further supporting the current Government policies in the UK. There should also be international considerations to continue promoting inclusivity and awareness of available ATech products.

# 5 Conclusion

The IATech Workshop at INTERACT 2023 served as a crucial platform to gain valuable insights into the challenges, developments and prospects within the field of ATech. This plays an essential role in enhancing the quality of life for individuals with disabilities and fostering an inclusive society. The insights and recommendations from the workshop contribute to a roadmap for enhancing ATech's awareness, accessibility and adoption.

The workshop featured five paper submissions and concluded with a panel discussion. The papers include a review of humanoid robots highlighting their benefits in social interaction and challenges in data privacy, the EduAbility Android application that provides ATech recommendations and training, as well as an ATech Innovator's Map to promote awareness of ATech for learning and ATech startups. Also presented was a case study for ATech co-production with an individual living with dystonia and an empirical study exploring the relationship between dyslexic characteristics and motivational factors in e-learning environments. These efforts reflect the commitment to ensuring that ATech products are not only technologically advanced but also accessible and inclusive, bridging the gap between those with disabilities and the vast world of technology. The panel with expertise and experience in the design, development and/or evaluation of ATech provided insightful discussions around challenges, lessons learnt and recommendations in the ATech domain. In the future, more endeavors should be given to develop low-cost solutions, training and adoption, engagement in co-design and co-production, and strengthening national and international networks to expand the reach of ATech awareness and accessibility. The panel emphasized the importance of user involvement, including end users, parents, caregivers, and healthcare professionals, along with streamlined usability evaluation techniques and standardized templates for requirements elicitation and specification tailored to ATech. Creating centralized databases for ATech products and integrating ATech in educational settings with facilities to train users are pivotal steps to ensure accessibility and informed choices for users and professionals. Multidisciplinary collaborations between academia, funding bodies and ATech developers, as well as short and long-term strategies for promoting awareness, will reinforce current policies and advocate for inclusivity and awareness
of ATech products. By addressing these aspects and continually promoting inclusivity through research and development, ATech can continue to enhance the quality of life for individuals with disabilities and work towards building a more equitable society.

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