Katherine Deibel Computer Science & Engineering University of Washington

1. Understanding and Supporting the Adoption of Assistive Technologies by Adults with Reading Disabilities Katherine Deibel Computer Science & Engineering University of Washington Dissertation Defense

2. Background on reading disabilities • Identification of a need • Development of an assistive reading tool • Evaluatory study • Demonstration of effectiveness Dissertation Defense

3. Defining AT Success • “When the participants used BookWise, “their mean reading rate increased 25 “wpm, or 16%, ...” q Elkind (1996) Performance Improvement Likelihood Of Being Used Success Dissertation Defense

4. 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) Dissertation Defense

5. 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? Dissertation Defense

6. 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 Dissertation Defense

7. 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 Dissertation Defense

8. Outline • Introduction • Background Value Sensitive Design Methodology VSD Research Highlights Conclusions and Future Work Dissertation Defense

9. Multiple Disciplines • Insights from many research areas: • Computer Science • Human-Computer Interaction • Assistive Technologies • Technology Adoption • Disability Studies • Education • Reading Sciences • Reading on Computers Dissertation Defense

10. 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? Dissertation Defense

11. 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) Dissertation Defense

12. Physical Traits • Letter misidentification • Word misidentification • Poor reading fluency/speed • Word ambiguity • Poor reading comprehension • Visual stress • Eye strain and fatigue • Distracted visual attention • Word and line skipping • Poor sequencing skills • Attention deficits • Less short-term memory • Slower recall • Visual memory issues • Poor motor coordination • Organization skills • Spelling difficulties • Writing difficulties • Strong spatial awareness • Abstract visualization • Good at lateral thinking • Talents in art and design Refs: Evans (2001); Edwards (1994); Everatt (1999); Peer & Reid (2001); Sands & Bucholz (1997); Wilcutt & Pennington (2000); Winner et al (2001); Wolf & Bowers(2000) Dissertation Defense

13. Physical Traits • Letter misidentification • Word misidentification • Poor reading fluency/speed • Word ambiguity • Poor reading comprehension • Visual stress • Eye strain and fatigue • Distracted visual attention • Word and line skipping • Poor sequencing skills • Attention deficits • Less short-term memory • Slower recall • Visual memory issues • Poor motor coordination • Organization skills • Spelling difficulties • Writing difficulties • Strong spatial awareness • Abstract visualization • Good at lateral thinking • Talents in art and design Memory Reading Writing Vision Strengths Refs: Evans (2001); Edwards (1994); Everatt (1999); Peer & Reid (2001); Sands & Bucholz (1997); Wilcutt & Pennington (2000); Winner et al (2001); Wolf & Bowers(2000) Dissertation Defense

14. 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) Dissertation Defense

15. Eight dyslexia “success” stories • Revelation of childhoods of: • Self-doubt • Depression • Feelings of isolation • Teasing from peers • Abuse from teachers • Expectations to fail • Reluctance to continue education despite admission to universities Janice Edwards (1994) Dissertation Defense

16. The Acquisition of a Child by a Learning Disability • McDermott (1993) • 8 year old Adam • Four different reading scenarios • Different levels of awareness of Adam’s RD by others • Worse performance with greater awareness Testing Sessions Classroom Lessons Cooking Club Everyday Life Dissertation Defense

17. 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) Dissertation Defense

18. 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) Dissertation Defense

19. 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? Dissertation Defense

20. 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) Dissertation Defense

21. 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) Dissertation Defense

22. 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) Dissertation Defense

23. 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) Dissertation Defense

24. 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) Dissertation Defense

25. Word misidentification • Poor reading fluency / speed • Word ambiguity • Poor reading comprehension • ColorOverlays • Visual stress • TTS • Eye strain and fatigue • Word and line skipping • Poor sequencing skills • Highlighting • Less short-term memory • Slower recall • Visual memory issues • Attention deficits • Poor motor coordination Letter misidentification ElectronicDictionary Dissertation Defense

26. 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 Dissertation Defense

27. 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) ** • K. Johnson (2008) ** • McRitchie (2010) ** Personal communications with AT specialists / researchers ** Study involved participants with RDs Dissertation Defense

28. Studies of Assistive Technology Adoption MANY Study involved RDs Study involved no RDs Types of Assistive Technologies ONE 0% 100% Focus on Reading Disabilities Dissertation Defense

29. Studies of Assistive Technology Adoption MANY Study involved RDs Study involved no RDs Adoption of specific assistive technologies Types of Assistive Technologies ONE 0% 100% Focus on Reading Disabilities Dissertation Defense

30. Studies of Assistive Technology Adoption MANY Study involved RDs Study involved no RDs No studies of general adoption by users with RDs Types of Assistive Technologies ONE 0% 100% Focus on Reading Disabilities Dissertation Defense

31. 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? Dissertation Defense

32. 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) Dissertation Defense

33. Diffusion of Innovations • Everett Rogers (1962, 2003) • General model of how new ideas and technology spread • Applied to multiple fields • Has adapted to changes in communication technologies Cumulative adoptions Number of adoptions Dissertation Defense

34. Diffusion of Innovations • Knowledge and adoption of technologies are guided by communication networks and visibility of use Dissertation Defense

35. 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 Dissertation Defense

36. Outline • Introduction • Background Value Sensitive Design Methodology Theory Agenda VSD Research Highlights Conclusions and Future Work Dissertation Defense

37. 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) Dissertation Defense

38. Human Values • What a person or group of people judge as important in life • Examples: • Privacy Trust • Human welfare Identity • Freedom from harm Autonomy Hiding and disclosure reflects values of privacy and identity Dissertation Defense

39. 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 Dissertation Defense

40. 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.) Dissertation Defense

41. Technical Investigation • Design and evaluate technology • Engineering methods Tripartite Methodology Conceptual Investigation • Identify relevant values and stakeholders • Philosophy informed Empirical Investigation • Confirm and refine values and stakeholders • Social science methods Dissertation Defense

42. Technical Investigation • Design and evaluate technology • Engineering methods Tripartite Methodology Conceptual Investigation • Identify relevant values and stakeholders • Philosophy informed Empirical Investigation • Confirm and refine values and stakeholders • Social science methods VSD methodology embraces multidisciplinary viewpoints Dissertation Defense

43. 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 Dissertation Defense

44. 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 Dissertation Defense

45. 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 Dissertation Defense

46. Outline • Introduction • Background Value Sensitive Design Methodology VSD Research Highlights Stakeholders Values Case Studies Technologies Conclusions and Future Work Dissertation Defense

47. 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 Dissertation Defense

48. 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 Dissertation Defense

49. 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 Dissertation Defense

50. Outline • Introduction • Background Value Sensitive Design Methodology VSD Research Highlights Stakeholders Values Case Studies Technologies Conclusions and Future Work Dissertation Defense