Abandonment (and lack of adoption in the first place)

1. Abandonment(and lack of adoption in the first place) Why technology designed to help, fails to do so

2. Expectations • 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 everything).

3. Expectations • 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.

4. Expectations • Doesn’t do what you expected it to do. • Not adaptable enough to meet specific needs.

5. Expectations • 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.

6. 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 people). What does this mean to you?

7. 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.

8. 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.

9. Social Aspects • Fear that the device will provide their child a crutch and they will stop working towards self-sufficiency.

10. Social Aspects - Attitude • Don’t believe it will work. • Feel isolated from the decision making process. • Cultural differences • Different cultures have different “solutions”

11. Social Aspects - Cosmetic • It makes me/my child look different • Its not me - Its not really them

12. 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.

13. Social Aspects - Cultural • Wrong language (e.g. H. learning to use English communication device at school, but goes home to Spanish speaking family).

14. 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 program. • Not enough tech. Support (e.g. Words+)

15. Difficulties for the User • Technology is intimidating - this is particularly true for the elderly. Kids jump right in.

16. 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 representations)

17. 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

18. 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.

19. 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).

20. 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).

21. 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

22. 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.

23. 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, 1999)

24. 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).

25. 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).

26. 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).

27. Solutions

28. Who can help? • Assistive technology specialists • Company spokespeople • Developers • Community

29. Assistive Technology Specialists • 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.

30. Assistive Technology Specialists • 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

31. Assistive Technology Specialists • 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.

32. Assistive Technology Specialists • Start simple so results can be seen immediately. • Make technology show off strengths before it shows off weaknesses. • Provide errorless instruction so the user doesn’t make mistakes and avoids frustration • Make sure you set-up a way out if the user makes a mistake.

33. Assistive Technology Specialists • 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.

34. Assistive Technology Specialists • Make sure the technology is adding to a persons life from their perspective and is not merely replacing.

35. Assistive Technology Specialists • 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.

36. Assistive Technology Specialists • 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 feedback?

37. Assistive Technology Specialists • Look at things like weight, durability and power supply

38. Assistive Technology Specialist • 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..”

39. Assistive Technology Specialist • Provide feedback to developers

40. Company Representatives • Don’t promise the answer to all their problems. • 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).

41. Company Representatives • Don’t make it look so easy. • Repair devices quickly.

42. Developers • 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.

43. Developers • 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.

44. Developers • Be sensitive to cosmetic aspects of devices. • Design it with multi-cultural icons and voices. • Design it with male and female icons and voices. • Design it to be useful in multiple languages.

45. Developers • Keep programming simple. • Allow for interface cross-over from other systems. • Make it like regular computer interfaces. vs • Keep it highly customizable. • Sensory issues • Cognitive load • Physical load • Feedback

46. Developers • Make it hard to break • Have a good power supply

47. Developers • Design it so people in the community can understand it.

48. Developers • Don’t impress people by sounding sophisticated.

49. Community • Become knowledgeable about assistive technology and peoples’ abilities. • Be helpful • Be open to different ways of doing things.

50. Questions? • What does the research say? • Percentage abandoned • Average time spent trying • Number of devices tried • Do certain devices provide a crutch which reduces learning?