Computers Helping People with Special Needs: 11th International Conference, ICCHP 2008, Linz, Austria, July 9-11, 2008, Proceedings

Lecture Notes in Computer Science Commenced Publication in 1973 Founding and Former Series Editors: Gerhard Goos, Juris Hartmanis, and Jan van Leeuwen

Editorial Board David Hutchison Lancaster University, UK Takeo Kanade Carnegie Mellon University, Pittsburgh, PA, USA Josef Kittler University of Surrey, Guildford, UK Jon M. Kleinberg Cornell University, Ithaca, NY, USA Alfred Kobsa University of California, Irvine, CA, USA Friedemann Mattern ETH Zurich, Switzerland John C. Mitchell Stanford University, CA, USA Moni Naor Weizmann Institute of Science, Rehovot, Israel Oscar Nierstrasz University of Bern, Switzerland C. Pandu Rangan Indian Institute of Technology, Madras, India Bernhard Steffen University of Dortmund, Germany Madhu Sudan Massachusetts Institute of Technology, MA, USA Demetri Terzopoulos University of California, Los Angeles, CA, USA Doug Tygar University of California, Berkeley, CA, USA Gerhard Weikum Max-Planck Institute of Computer Science, Saarbruecken, Germany

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Klaus Miesenberger Joachim Klaus Wolfgang Zagler Arthur Karshmer (Eds.)

Computers Helping People with Special Needs 11th International Conference, ICCHP 2008 Linz, Austria, July 9-11, 2008 Proceedings

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Volume Editors Klaus Miesenberger Johannes Kepler University Linz, Institute Integriert Studieren Altenberger Strasse 69, 4040 Linz, Austria E-mail: [email protected] Joachim Klaus University of Karlsruhe (TH), Study Center for the Visually Impaired Students Engesserstr. 4, 76131 Karlsruhe, Germany E-mail: [email protected] Wolfgang Zagler Vienna University of Technology, Institute "Integriert Studieren" Favoritenstr. 11/029, 1040 Vienna, Austria E-mail: [email protected] Arthur Karshmer University of San Francisco 2130 Fulton St., San Francisco, CA 94117, USA E-mail: [email protected]

Library of Congress Control Number: 2008930487 CR Subject Classification (1998): H.5.2, H.5.3, H.3, H.4, K.4, K.3 LNCS Sublibrary: SL 3 – Information Systems and Application, incl. Internet/Web and HCI ISSN ISBN-10 ISBN-13

0302-9743 3-540-70539-2 Springer Berlin Heidelberg New York 978-3-540-70539-0 Springer Berlin Heidelberg New York

This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, re-use of illustrations, recitation, broadcasting, reproduction on microfilms or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the German Copyright Law. Springer is a part of Springer Science+Business Media springer.com © Springer-Verlag Berlin Heidelberg 2008 Printed in Germany Typesetting: Camera-ready by author, data conversion by Scientific Publishing Services, Chennai, India Printed on acid-free paper SPIN: 12326709 06/3180 543210

Preface

Welcome to the proceedings of ICCHP 2008. We were proud to welcome participants from more than 40 countries from all continents to ICCHP. The International Programme Committee, encompassing 102 experts form all over the world, selected 150 full and 40 short papers out of 360 abstracts submitted to ICCHP. Our acceptance rate of about half of the submissions, demonstrates the scientific quality of the programme and in particular the proceedings you have in your hands. An impressive group of experts agreed to organize “Special Thematic Sessions” (STS) for ICCHP 2008. The existence of these STS sessions helped to bring the meeting into sharper focus in several key areas of assistive technology. In turn, this deeper level of focus helped to bring together the state-of-the-art and mainstream technical, social, cultural and political developments. Our keynote speaker, Jim Fruchterman from BeneTech, USA highlighted the importance of giving access to ICT and AT at a global level. In another keynote by Harold Thimbleby, Swansea University, UK, the role of user-centred design and usability engineering in assistive technology and accessibility was addressed. And finally, a combination keynote and panel discussion was reserved for WAI/WCAG2.0, which we expect to be the new reference point for Web accessibility from the summer of 2008 and beyond. The programme was accompanied by a German-spoken event called “IKT Forum,” which brought together more than 200 practitioners. With an interesting workshop programme, meetings, an exhibition including presentations and demonstrations of major software and assistive technology producers and vendors, ICCHP once again fulfilled its mission of an international meeting place and a center of advanced information exchange . Since the late 1980s it has been ICCHP’s mission to support and reflect the development of the field of “assistive technologies,” eAccessibility and eInclusion. With a focus on scientific quality, ICCHP has become an important reference in our field for mainstream. We hope that this conference and this collection of papers will once again fulfil this role. ICCHP 2008 was held under the auspices of Heinz Fischer, President of the Federal Republic of Austria. We would also like to thank all supporters and sponsors. Our special thanks go to those contributing to put this conference in place: General ICCHP 2006 Chair, H. J. Murphy, Founder, Former Director and Member Advisory Board of the Center on Disabilities, California State University, Northridge, USA

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Preface

Programme Chairs University of San Francisco, USA INSERM, France Kyushu University, Japan Vienna University of Technology, Austria Universität Karlsruhe (TH), Germany University of Linz, Austria

Karshmer, A. Burger, D. Suzuki, M. Tjoa, A. M. Vollmar, R. Wagner, R.

Publishing Chairs Klaus, J. Miesenberger, K Zagler, W.

Universität Karlsruhe (TH), Germany University of Linz, Austria Vienna University of Technology, Austria

Young Researchers Consortium Chairs Alm, N. Archambault, D. Blenkhorn, P. Fitzpatrick, D. Kobayashi, M. Pontelli, E. Sinclair, R. Weber, G.

Dundee University, UK Université Piere et Marie Curie, France University of Manchester, UK Dublin City University, Ireland Tsukuba College of Technology, Japan New Mexico State University, USA Microsoft, USA Technische Universität Dresden, Germany

Programme Committee Abascal, J. Abu-Ali, A. Abou-Zahra, S. Andrich, R. Arató, A. Arató, P. Azevedo, L. Batusic, M. Bernareggi, C. Bothe, H.-H. Brewster, S. Brown, D. Bühler, C. Cummins Prager, M. Craddock, G.

Euskal Herriko Univertsitatea, Spain Philadelphia University, Jordan World Wide Web Consortium (W3C), Austria Polo Tecnologico Fondazione Don Carlo Gnocchi Onlus, Italy KFKI-RMKI, Hungary TU Budapest, Hungary Instituto Superior Tecnico, Portugal University of Linz, Austria Universita degli Studi di Milano, Italy Technical University of Denmark, Denmark University of Glasgow, UK The Nottingham Trent University, UK University of Dortmund, FTB, Germany California State University Northridge, USA Centre for Excellence in Universal Design, Ireland

Preface

Crombie, D. Darvishy, A. Darzentas, J. DeRuyter, F. Diaz del Campo, R. Dotter, F. Edwards, A. Emiliani, P.L. Engelen, J. Evreinov, G. Fels, D Freitas, D. Fruchterman, J. Gardner, J. Gupta, G. Harper, S. Holzinger, A. Ioannidis, G Jemni, M. Jutai, J. Knops, H. Koronios, A. Kremser, W. Lauruska, V. Leahy, D. Magnussen, M. Mathiassen, N. McKenzie, N. McMullin, B. Mendelova, E. Mokhtari, M. Neveryd, H. Nicolle, C. . Nischelwitzer, A. Nussbaum, G. Okamoto, A. Ono, T. Paciello, M. Panek, P. Penaz, P. Petrie, H Petz, A. Prazak, B. Pühretmair, F. Quirchmayr, G.

European Adaptive Content Network (EUAIN), The Netherlands Züricher Hochschule für Ang. Wissenschaften, Switzerland University of the Aegean, Greece Duke University Medical Center, USA Antarq Tecnosoluciones, Mexico Universität Klagenfurt, Austria University of York, UK Istituto di Fisica Applicata ‘Nello Carrara’, Italy Katholieke Universiteit Leuven, Belgium University of Tampere, Finland Ryerson University, Canada University of Porto, Portugal Beneficent Technology, USA Oregon State University, USA University of Texas at Dallas, USA University of Manchester, UK Graz University Hospital, Austria University of Bremen, Germany University of Tunis, Tunisia The University of Western Ontario, Canada NG4All, The Netherlands University of South Australia, Australia OCG, HSM, Austria Siauliai University, Lithuania Trinity College Dublin, Ireland THF, Sweden Danish Centre for Assistive Technology, Denmark DEDICON, The Netherlands Dublin City University, Ireland Comenius University of Bratislava, Slovak Republic Inst. Nat. Supérieur des Télécommunications, France Lund University, Sweden Loughborough University, UK FH Johaneum, Austria KI-I, Austria Tsukuba University of Technology, Japan Tsukuba University of Technology, Japan The Paciello Group, USA Vienna University of Technology, Austria University of Brno, Czech Republic University of York, UK University of Linz, Austria Austrian Research Centres, Austria KI-I, Austria University of Vienna, Austria

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Preface

Raisamo, R. Rauhala, M. Salminen, A. Scadden, L. Schweikhardt, W. Schwerdtfeger, R. Snaprud, M. Soede, T. Steiner, D. Stephanidis, C. Stoeger, B. Strauss, Ch. Svensson, H. Tahkokallio, P. Traunmüller, R. Trehin, P. Treviranus, J. Vaspöri, T. Velasco, C. Vigouroux, N. Wagner, G. Wöß, W.

University of Tampere, Finland Vienna University of Technology, Austria Stakes, Finland Independent Consultant on AT, USA University of Stuttgart, Germany IBM, USA Agder University, Norway Zuyd University, The Netherlands University of Linz, Austria ICS-FORTH, Greece University of Linz, Austria University of Vienna, Austria National Institute for Special Needs Education, Sweden Stakes, Finland University of Linz. Austria World Autism Organisation, Belgium University of Toronto, Canada KFKI-RMKI, Hungary Fraunhofer Institute for Appl. IT, Germany IRIT Toulouse, France University of Applied Sciences Steyr, Austria University of Linz, Austria

Organizing Committee (University of Linz) Arrer, B. Matausch, K. Petz, A.

Feichtenschlager, P. Miesenberger, K. Ruemer, R.

Hengstberger, B. Ossmann, R. Schult, C.

We thank the Austrian Computer Society for announcing and sponsoring the Roland Wagner Award on Computers Helping People with Special Needs. The Austrian Computer Society decided in September 2001 to endow this award in honor of Prof. Dr. Roland Wagner, the founder of ICCHP. The Roland Wagner Award is a biannual award in the range of €€ 3000. It will be handed over at the occasion of ICCHP conferences.

Award Winners Award 0: Prof. Dr. Roland Wagner on the occasion of his 50th birthday, 2001 Award 1: WAI-W3C, ICCHP 2002 in Linz Special Award 2003: A Min Tjoa, Vienna University of Technology on the occasion of his 50th birthday Award 2: Paul Blenkhorn, University of Manchester, ICCHP 2004 in Paris Award 3: Lary Scadden, National Science Foundation, ICCHP 2006 in Linz Special Award 2006: Roland Traunmüller, University of Linz

Preface

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Once again we thank all those helping in putting ICCHP in place and thereby supporting the AT field and a better quality of life for people with disabilities.

July 2008

Klaus Miesenberger Joachim Klaus Arthur Karshmer Wolfgang Zagler

Table of Contents

Keynote Understanding User Centred Design (UCD) for People with Special Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Harold Thimbleby

1

Human-Computer Interaction and Usability for Elderly (HCI4AGING) Introduction to the Special Thematic Session: Human–Computer Interaction and Usability for Elderly (HCI4AGING) . . . . . . . . . . . . . . . . . . Andreas Holzinger, Kizito Ssamula Mukasa, and Alexander K. Nischelwitzer An Investigation on Acceptance of Ubiquitous Devices for the Elderly in a Geriatric Hospital Environment: Using the Example of Person Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Andreas Holzinger, Klaus Schaupp, and Walter Eder-Halbedl Adaptive Interfaces for Supportive Ambient Intelligence Environments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Julio Abascal, Isabel Fern´ andez de Castro, Alberto Lafuente, and Jesus Maria Cia Natural Interaction between Avatars and Persons with Alzheimer’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Eduardo Carrasco, Gorka Epelde, Aitor Moreno, Amalia Ortiz, Igor Garcia, Cristina Buiza, Elena Urdaneta, Aitziber Etxaniz, Mari Feli Gonz´ alez, and Andoni Arruti

18

22

30

38

Exploring the Role of Time and Errors in Real-Life Usability for Older People and ICT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sergio Sayago and Josep Blat

46

An Acoustic Framework for Detecting Fatigue in Speech Based Human-Computer-Interaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Jarek Krajewski, Rainer Wieland, and Anton Batliner

54

Visual and Auditory Interfaces of Advanced Driver Assistant Systems for Older Drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Martina Ziefle, Preethy Pappachan, Eva-Maria Jakobs, and Henning Wallentowitz

62

XII

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Eye Tracking Impact on Quality-of-Life of ALS Patients . . . . . . . . . . . . . . Andrea Calvo, Adriano Chi` o, Emiliano Castellina, Fulvio Corno, Laura Farinetti, Paolo Ghiglione, Valentina Pasian, and Alessandro Vignola

70

Participative Approaches for “Technology and Autonomous Living” . . . . Ulrike Bechtold and Mahshid Sotoudeh

78

From Cultural to Individual Adaptive End-User Interfaces: Helping People with Special Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . R¨ udiger Heimg¨ artner, Andreas Holzinger, and Ray Adams

82

Effects of Icon Concreteness and Complexity on Semantic Transparency: Younger vs. Older Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sabine Schr¨ oder and Martina Ziefle

90

Investigating Usability Metrics for the Design and Development of Applications for the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Andreas Holzinger, Gig Searle, Thomas Kleinberger, Ahmed Seffah, and Homa Javahery

98

Design for All: From Idea to Practice Design for All – from Idea to Practise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Christian B¨ uhler User Modelling in Ambient Intelligence for Elderly and Disabled People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Roberto Casas, Rub´en Blasco Mar´ın, Alexia Robinet, Armando Roy Delgado, Armando Roy Yarza, John McGinn, Richard Picking, and Vic Grout

106

114

Design for All in the Ambient Intelligence Environment . . . . . . . . . . . . . . . P.L. Emiliani, M. Billi, L. Burzagli, and F. Gabbanini

123

Creating Innovative Partnerships with Users in Developing Assistive Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Norman Alm and Alan Newell

130

Public Signs Sight Assessment for Low Vision through Eye Tracking . . . . Hisayuki Tatsumi, Yasuyuki Murai, Iwao Sekita, and Masahiro Miyakawa

138

Visual Tools for Accessible Computer Supported Collaboration . . . . . . . . Antti Raike, Joanna Saad-Sulonen, J¨ urgen Scheible, Roman Suzi, and Tarmo Toikkanen

142

Table of Contents

XIII

Supporting Industry in the Development of Design for All Curriculum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yehya Mohamad, Stefan Carmien, and Carlos A. Velasco

150

European Developments in the Design and Implementation of Training for eInclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Gill Whitney and Suzette Keith

156

(Users Need Standards)2 – Users Need Standards Need Users Users with Disabilities and Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Christian B¨ uhler

162

AT and DfA Standardisation: What Is Currently Going on? . . . . . . . . . . . Jan Engelen

166

Using Public Procurement to Ensure That Accessible ICT Products and Services Are Available for All European Citizens (ETSI HF STF 333) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Richard Hodgkinson

170

Accessibility: Education for Web Design and eLearning Accessibility: Education for Web Design and E-Learning: Introduction to the Special Thematic Session . . . . . . . . . . . . . . . . . . . . . . . . Jenny Craven and Joachim Klaus Joint Study Programme on Accessible Web Design . . . . . . . . . . . . . . . . . . . Barbara Hengstberger, Klaus Miesenberger, Mario Batusic, Noura Chelbat, and Andr´es Rodr´ıguez Garc´ıa Design of a 10 Credit Masters Level Assistive Technologies and Universal Design Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mike Wald Experiential Coe-Tutoring: A Report on Taiwan’s OpenStudy Project That Seeks Innovative Accessible E-Learning Methodologies . . . . . . . . . . . Arrmien M. Chou, Yaoming Yeh, Shumei Keng, Chenchuan C. Chen, and Tingyu Huang

178 182

190

194

Using a Computer Aided Test to Raise Awareness of Disability Issues amongst University Teaching Staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . John Gray, Gill Harrison, Jakki Sheridan-Ross, and Andrea Gorra

198

The Impact of Information Communication Technologies (ICTs) on Diverse Students and Teachers at Second Level . . . . . . . . . . . . . . . . . . . . . . Cara Nicole Greene

207

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Round Peg, Square Hole: Supporting Via the Web Staff and Learners Who Do Not Fit into Traditional Learner-Teacher-Institution Scenarios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Simon Ball and Alistair McNaught

215

Distance Learning of Graphically Intensive Material for Visually Impaired Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Donal Fitzpatrick and Declan McMullen

219

M-Learning Accessibility Design: A Case Study . . . . . . . . . . . . . . . . . . . . . . Marco Arrigo, Gaspare Novara, and Giovanni Cipr`ı

226

ACP – Accessible Content Processing Accessible Content Processing: Introduction to the Special Thematic Session . . . . . . . . . . . . . . . . . . . . . . . . David Crombie and Jan Engelen Automated Drug Information System for Aged and Visually Impaired Persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G´eza N´emeth, G´ abor Olaszy, M´ aty´ as Bartalis, G´eza Kiss, Csaba Zaink´ o, P´eter Mihajlik, and Csaba Haraszti

234

238

A Semi-automatic Support to Adapt E-Documents in an Accessible and Usable Format for Vision Impaired Users . . . . . . . . . . . . . . . . . . . . . . . . Elia Contini, Barbara Leporini, and Fabio Patern` o

242

Accessibility for Blind Users: An Innovative Framework . . . . . . . . . . . . . . . Elisa Rubegni, Paolo Paolini, Alberto Terragni, and Stefano Vaghi

250

User Testing: How to Involve Users in Technical Web Development Cycles as a Natural Evolution in the Creation of Inclusive Technologies and Accessible Content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Joshue O. Connor

258

Accessibility Standards Are Not Always Enough: The Development of the Accessibility Passport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Simon Ball and John Sewell

264

DAISY – Universally Designed? Prototyping an Approach to Measuring Universal Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Miriam Eileen Nes, Kirsten Ribu, and Morten Tollefsen

268

A System for Dynamic Adaptation of Web Interfaces Based on User Interaction Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Javier Gonzalez-Pisano, Maria Rodriguez-Fernandez, Martin Gonzalez-Rodriguez, Jose Ramon Bobes-Bascaran, and Jaime Garcia-Marsa

276

Table of Contents

XV

Modern Digital Libraries, the Case of the Audio-Book Boom . . . . . . . . . . Jan Engelen

284

Xerte – A User-Friendly Tool for Creating Accessible Learning Objects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Simon Ball and Julian Tenney

291

GATE to Accessibility of Computer Graphics . . . . . . . . . . . . . . . . . . . . . . . . Ivan Kopeˇcek and Radek Oˇslejˇsek

295

CONTRAPUNCTUS Project: A New Computer Solution for Braille Music Fruition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Giuseppe Nicotra and Antonio Quatraro

303

BMML: A Mark-Up Language for Braille Music . . . . . . . . . . . . . . . . . . . . . Enrico Bortolazzi, Nadine Baptiste-Jessel, and Giovanni Bertoni

310

Automated Book Reader Design for Persons with Blindness . . . . . . . . . . . Lu Wang and Malek Adjouadi

318

Making Conference CDs Accessible: A Practical Example . . . . . . . . . . . . . Marion Hersh and Barbara Leporini

326

Web Accessibility – Automatic/Manual Evaluation and Authoring Tools Web Accessibility – Automatic/Manual Evaluation and Authoring Tools: Introduction to the Special Thematic Session . . . . . . . . . . . . . . . . . . Helen Petrie, Christopher Power, and Gerhard Weber

334

A Software Solution for Accessible E-Government Portals . . . . . . . . . . . . . Dietmar Nedbal and Gerald Petz

338

A Development Toolkit for Unified Web-Based User Interfaces . . . . . . . . . C. Doulgeraki, N. Partarakis, A. Mourouzis, and C. Stephanidis

346

Automatic Creation of User Profiles for Achieving Personal Web Accessibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Markel Vigo, Amaia Aizpurua, Myriam Arrue, and Julio Abascal

354

Accessible Flash Is No Oxymoron: A Case Study in E-Learning for Blind and Sighted Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Maria Kr¨ uger

362

Building Accessible Flash Applications: An XML-Based Toolkit . . . . . . . . ´ Paloma Cant´ on, Angel L. Gonz´ alez, Gonzalo Mariscal, and Carlos Ruiz

370

XVI

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Accessible Graphics in Web Applications: Dynamic Generation, Analysis and Verification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kerstin Altmanninger and Wolfram W¨ oß

378

Analysing the 2D, 3D and Web User Interface Navigation Structures of Normal Users and Users with Mild Intellectual Disabilities . . . . . . . . . . . . Rita M´ atrai, Zsolt T. Koszty´ an, and Cec´ılia Sik-L´ anyi

386

The Unified Web Evaluation Methodology (UWEM) 1.2 for WCAG 1.0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Annika Nietzio, Christophe Strobbe, and Eric Velleman

394

The BenToWeb Test Case Suites for the Web Content Accessibility Guidelines (WCAG) 2.0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Christophe Strobbe, Johannes Koch, Evangelos Vlachogiannis, Reinhard Ruemer, Carlos A. Velasco, and Jan Engelen Monitoring Accessibility of Governmental Web Sites in Europe . . . . . . . . Christian B¨ uhler, Helmut Heck, Annika Nietzio, Morten Goodwin Olsen, and Mikael Snaprud

402

410

Web Accessibility – Quality Control and Best Practice Proposal for a Structure Mark-Up Supporting Accessibility for the Next Generation (X)HTML-Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Gerhard Nussbaum, Mario Batusic, Claudia Fahrengruber, and Klaus Miesenberger

418

Improving Web Form Accessibility Using Semantic XForms for People with Cognitive Impairments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Amin Anjomshoaa, Muhammad Shuaib Karim, and A Min Tjoa

426

Improving the Accessibility of Wikis: A Basic Analytical Framework . . . . C. Taras, O. Siemoneit, N. Weißer, M. Rotard, and T. Ertl

430

Requirements of Users with Disabilities for E-government Services in Greece . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . George Margetis, Stavroula Ntoa, and Constantine Stephanidis

438

Tools for Deaf Accessibility to an eGOV Environment . . . . . . . . . . . . . . . . Stavroula-Evita Fotinea and Eleni Efthimiou

446

Using Web Content Management Systems for Accessibility: The Experience of a Research Institute Portal . . . . . . . . . . . . . . . . . . . . . . . . . . . Laura Burzagli, Francesco Gabbanini, Marco Natalini, Enrico Palchetti, and Alessandro Agostini

454

Table of Contents

Accessible Online Shops for the Older Generation and People with Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Michael Stenitzer, Maria Putzhuber, Sascha Nemecek, and Fabian B¨ uchler

XVII

462

WebGen System - Visually Impaired Users Create Web Pages . . . . . . . . . Ludˇek B´ artek and Jarom´ır Plh´ ak

466

An Accessible Media Player as a User Agent for the Web . . . . . . . . . . . . . A. Mourouzis, N. Partarakis, C. Doulgeraki, C. Galanakis, and C. Stephanidis

474

Usability and Accessibility on the Internet: Effects of Accessible Web Design on Usability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Wolfram Huber and Peter Vitouch

482

Exploratory Case Study Research on Web Accessibility . . . . . . . . . . . . . . . Marie-Luise Leitner and Christine Strauss

490

Web Accessible and Mobile: The Relationship between Mobile Web Best Practices and Web Content Accessibility Guidelines . . . . . . . . . . . . . . Alan Chuter

498

People with Disabilities: Software Accessibility Making Business Software Usable for Handicapped Employees . . . . . . . . . Annett Hardt and Martin Schrepp

502

Quality Processes and Milestones for the Development and Monitoring of Business Software in the Area of Accessibility . . . . . . . . . . . . . . . . . . . . . Dewi Gani and Urte Th¨ olke

510

Accessibility of Educational Software: From Evaluation to Design Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Serenella Besio, Elena Laudanna, Francesca Potenza, Lucia Ferlino, and Federico Occhionero How Can Java Be Made Blind-Friendly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Norbert Markus, Zoltan Juhasz, Gabor Bognar, and Andras Arato Requirements for a Method of Software Accessibility Conformity Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ´ Fernando Alonso, Jos´e L. Fuertes, Angel L. Gonz´ alez, and Lo¨ıc Mart´ınez

518

526

534

Entertainment Software Accessibility Towards Generalised Accessibility of Computer Games: Introduction to the Special Thematic Session . . . . . . . . . . . . . . . . . . . . . . . . Dominique Archambault, Roland Ossmann, and Klaus Miesenberger

542

XVIII

Table of Contents

Profiling Robot-Mediated Play for Children with Disabilities through ICF-CY: The Example of the European Project IROMEC . . . . . . . . . . . . . Serenella Besio, Francesca Caprino, and Elena Laudanna MP3 Players and Audio Games: An Alternative to Portable Video Games Console for Visually Impaired Players . . . . . . . . . . . . . . . . . . . . . . . . Alexis Sepchat, Simon Descarpentries, Nicolas Monmarch´e, and Mohamed Slimane

545

553

Non-visual Gameplay: Making Board Games Easy and Fun . . . . . . . . . . . . Tatiana V. Evreinova, Grigori Evreinov, and Roope Raisamo

561

An Accessible Viewer for Digital Comic Books . . . . . . . . . . . . . . . . . . . . . . . Christophe Ponsard and Vincent Fries

569

Flexible and Simple User Interfaces in Entertaining Software . . . . . . . . . . Morten Tollefsen and Are Flyen

578

A Computer Game Designed for All . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Roland Ossmann, Klaus Miesenberger, and Dominique Archambault

585

Artificial Ants and Dynamical Adaptation of Accessible Games Level . . . Alexis Sepchat, Romain Clair, Nicolas Monmarch´e, and Mohamed Slimane

593

Accessibility Issues in Game-Like Interfaces . . . . . . . . . . . . . . . . . . . . . . . . . Roland Ossmann, Dominique Archambault, and Klaus Miesenberger

601

Hearing Impaired, Deaf and DeafBlind People: HCI and Communication Human Computer Interaction and Communication Aids for Hearing-Impaired, Deaf and Deaf-Blind People: Introduction to the Special Thematic Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hans-Heinrich Bothe

605

EnACT: A Software Tool for Creating Animated Text Captions . . . . . . . . Quoc V. Vy, Jorge A. Mori, David W. Fourney, and Deborah I. Fels

609

Captioning Multiple Speakers Using Speech Recognition to Assist Disabled People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mike Wald

617

Extracting Pointing Object with Demonstrative Speech Phrase for Remote Transcription in Lecture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yoshinori Takeuchi, Ken Saito, Ayaka Ito, Noboru Ohnishi, Shigeyoshi Iizuka, and Shinya Nakajima

624

Table of Contents

A Study on Demonstrative Words Extraction in Instructor Utterance on Communication Support for Hearing Impaired Persons . . . . . . . . . . . . . Ayaka Ito, Ken Saito, Yoshinori Takeuchi, Noboru Ohnishi, Shigeyoshi Iizuka, and Shinya Nakajima Development of a Web Type DVD Viewer Synchronized with Multilingual Captions for Existing DVDs . . . . . . . . . . . . . . . . . . . . . . . . . . . Takaaki Okura and Yoko Hirose Support Technique for Real-Time Captionist to Use Speech Recognition Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Shigeki Miyoshi, Hayato Kuroki, Sumihiro Kawano, Mayumi Shirasawa, Yasushi Ishihara, and Masayuki Kobayashi New Real-Time Closed-Captioning System for Japanese Broadcast News Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Shinichi Homma, Akio Kobayashi, Takahiro Oku, Shoei Sato, Toru Imai, and Tohru Takagi

XIX

632

640

647

651

eRehabilitation: A Portal Framework for Aural Rehabilitation . . . . . . . . . Dimitar Denev, Sion Morris, Carlos A. Velasco, and Yehya Mohamad

655

Multimedia Interfaces for BSL Using Lip Readers . . . . . . . . . . . . . . . . . . . . Faramaz Eyasim Joumun, Paul Gnanayutham, and Jennifer George

663

A System to Make Signs Using Collaborative Approach . . . . . . . . . . . . . . . Mohamed Jemni and Oussama Elghoul

670

Application System of the Universal Sign Code - Development of the Portable Sign Presenter - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tsutomu Kimura, Masanori Katoh, Atsushi Hayashi, Kazuyuki Kanda, Daisuke Hara, and Kazunari Morimoto Body-Braille System for Disabled People . . . . . . . . . . . . . . . . . . . . . . . . . . . . Satoshi Ohtsuka, Nobuyuki Sasaki, Sadao Hasegawa, and Tetsumi Harakawa Dialog Support for Deafblind Persons by Conveying Backchannels through Vibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Misako Nambu, Akira Okamoto, Shigeki Miyoshi, and Masatsugu Sakajiri

678

682

686

People with Specific Learning Dificulties – Easy to Read and HCI People with Specific Learning Difficulties: Easy to Read and HCI: Introduction to the Special Thematic Session . . . . . . . . . . . . . . . . . . . . . . . . Andrea Petz and Bror Tronbacke

690

XX

Table of Contents

Using Expert System to Assist Mouse Proficiency Assessment . . . . . . . . . Chih-Ching Yeh, Ming-Chung Chen, Yao-Ming Yeh, Hwa-Pey Wang, Chi-Nung Chu, and Chien-Chuan Ko

693

Naming Game – An Automated Tool for Analyzing and Practicing Rapid Serial Naming on Dyslexic Persons . . . . . . . . . . . . . . . . . . . . . . . . . . . Jyrki Rissanen

700

Cognitive Abilities of Functionally Illiterate Persons Relevant to ICT Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sabine van Linden and Anita H.M. Cremers

705

User-Centered Design with Illiterate Persons: The Case of the ATM User Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Anita H.M. Cremers, Jacomien G.M. de Jong, and Johan S. van Balken Analysis and Adaptation of Workplaces for People with Cognitive Disabilities Using Software Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Alberto Ferreras, Alicia Piedrabuena, Juan Manuel Belda, Ricard Barber` a, Alfonso Oltra, Rakel Poveda, Jaime Prat, and Lourdes Tortosa Tutor Project: An Intelligent Tutoring System to Improve Cognitive Disabled People Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J. Rubio, C. Vaquero, J.M. L´ opez de Ipi˜ na, E. Irigoyen, K.L. de Ipi˜ na, N. Garay, A. Conde, M. Larra˜ naga, A. Ezeiza, A. Soraluze, M. Pe˜ nagarikano, G. Bordel, L.J. Rodr´ıguez, J.M. L´ opez, M. Ezquerra, and D. Oregi

713

721

729

Adaptive Spell Checker for Dyslexic Writers . . . . . . . . . . . . . . . . . . . . . . . . . Tuomas Korhonen

733

Dyslexia: Study of Compensatory Software Which Aids the Mathematical Learning Process of Dyslexic Students at Secondary School and University . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Corinna Freda, Silvio Marcello Pagliara, Fiorentino Ferraro, Francesco Zanfardino, and Alessandro Pepino

742

The Effectiveness of TriAccess Reading System on Comprehending Nature Science Text for Students with Learning Disabilities . . . . . . . . . . . Ming-Chung Chen, Chun-Han Chiang, and Chien-Chuan Ko

747

Usable and Accessible Plain Language (Easy-to-Read) Network Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ Sami Alli, Kimmo Kyyhkynen, and Marianna Ohtonen

755

The Design of Talking Music Web Browser for Teaching Learning-Disabled Children: A Scaffolding Strategy to Aural Skills . . . . . Yu-Ting Huang, Chi Nung Chu, Yao-Ming Yeh, and Pei-Luen Tsai

759

Table of Contents

Information Center on Accessible Information . . . . . . . . . . . . . . . . . . . . . . . Kerstin Matausch and Birgit Peb¨ ock

XXI

763

Blind and Visually Impaired People: Human-Computer Interaction and Access to Graphics Blind and Visually Impaired People: Human-Computer Interaction and Access to Graphics: Introduction to the Special Thematic Session . . . . . . . . . . . . . . . . . . . . . . . . Ilvio Bruder and Gerhard Jaworek

767

Making the I-Maestro Music Learning Framework Accessible . . . . . . . . . . Neil McKenzie and Benjie Marwick-Johnstone

770

Voice Browser for Groupware Systems: VoBG - A Simple Groupware Client for Visually Impaired Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Makoto Kobayashi

777

Making ProTools Accessible for Visually Impaired . . . . . . . . . . . . . . . . . . . . Tom´ aˇs Zahradnick´y, R´ obert L´ orencz, and Pavel Musil

781

User-Interface Modelling for Blind Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . ´ Fernando Alonso, Jos´e L. Fuertes, Angel L. Gonz´ alez, and Lo¨ıc Mart´ınez

789

Towards an Open Source Screen Reader: Screenreader Usability Extensions (SUE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Andrea Gaal, Gerhard Jaworek, Joachim Klaus, Martina Weicht, Frank Zenker, Ilvio Bruder, Antje D¨ usterh¨ oft, and Andreas Heuer

797

ZoomLinux: A Research Result Providing a Tangible Response to the Needs of Low Vision Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Giovanni Paolo Caruso, Silvia Dini, and Lucia Ferlino

801

An Analysis of Human-to-Human Dialogs and Its Application to Assist Visually-Impaired People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Takuya Nishimoto and Takayuki Watanabe

809

Learning Support System Based on Note-Taking Method for People with Acquired Visual Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kazuyuki Itou, Baku Kato, Masaru Taniguchi, Toshio Otogawa, Kazuyuki Itoh, Kimiyasu Kiyota, Nobuo Ezaki, and Keiichi Uchimura Dot Detection of Optical Braille Images for Braille Cells Recognition . . . Amany Al-Saleh, Ali El-Zaart, and AbdulMalik AlSalman

813

821

XXII

Table of Contents

Developing Multimedia-Game Software to Improve Space and Depth Perception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cec´ılia Sik L´ anyi and L´ aszl´ o Galyas

827

Tactile Graphics Revised: The Novel BrailleDis 9000 Pin-Matrix Device with Multitouch Input . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Thorsten V¨ olkel, Gerhard Weber, and Ulrich Baumann

835

Sensitive Braille Displays with ATC Technology (Active Tactile Control) as a Tool for Learning Braille . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Siegfried Kipke

843

Dual Mode Fingertip Guiding Manipulator for Blind Persons Enabling Passive/Active Line-Drawing Explorations . . . . . . . . . . . . . . . . . . . . . . . . . . Syed Muammar Najib Syed Yusoh, Yoshihiko Nomura, Naomi Kokubo, Tokuhiro Sugiura, Hirokazu Matsui, and Norihiko Kato Toward Touching a Landscape in a Picture: Investigation of Groping Strategy about Tactile Images and Image Simplification Method . . . . . . . Takayuki Shiose, Yasuhiro Kagiyama, Kiyohide Ito, Kazuhiko Mamada, Hiroshi Kawakami, and Osamu Katai An Off-Screen Model for Tactile Graphical User Interfaces . . . . . . . . . . . . Michael Kraus, Thorsten V¨ olkel, and Gerhard Weber

851

859

865

Access to Mathematics and Science Access to Mathematics and Science: Introduction to the Special Thematic Session . . . . . . . . . . . . . . . . . . . . . . . . Arthur I. Karshmer

873

Multimedia MathReader for Daisy Books . . . . . . . . . . . . . . . . . . . . . . . . . . . Piotr Brzoza

875

Writing Mathematics by Speech: A Case Study for Visually Impaired . . . Cristian Bernareggi and Valeria Brigatti

879

Universal Authoring System for Braille Materials by Collaboration of UMCL and Infty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Toshihiro Kanahori, Dominique Archambault, and Masakazu Suzuki

883

Assessing the Mathematics Related Communication Requirements of the Blind in Education and Career . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Paul Stanley

888

New Features in Math Accessibility with Infty Software . . . . . . . . . . . . . . . Katsuhito Yamaguchi, Toshihiko Komada, Fukashi Kawane, and Masakazu Suzuki

892

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XXIII

Making Arithmetic Accessible . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . John A. Gardner, Carolyn K. Gardner, Blake Jones, and Elizabeth Jones

900

Learning Math for Visually Impaired Users . . . . . . . . . . . . . . . . . . . . . . . . . . Thimoty Barbieri, Lorenzo Mosca, and Licia Sbattella

907

Manipulatives in the History of Teaching: Fast Forward to AutOMathic Blocks for the Blind . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Arthur I. Karshmer and Daryoush Farsi

915

Braille-Embedded Tactile Graphics Editor with Infty System . . . . . . . . . . Toshihiro Kanahori, Masayuki Naka, and Masakazu Suzuki

919

Access to Mathematics in Web Resources for People with a Visual Impairment: Considerations and Developments in an Open and Distance Learning Context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Martyn Cooper, Tim Lowe, and Mary Taylor Multimodal Exploration and Manipulation of Graph Structures . . . . . . . . Cristian Bernareggi, Christian Comaschi, Giancarlo Dalto, Piero Mussio, and Loredana Parasiliti Provenza The Development of a Universal Design Tactile Graphics Production System BPLOT2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mamoru Fujiyoshi, Akio Fujiyoshi, Nobuyuki Ohtake, Katsuhito Yamaguchi, and Yoshinori Teshima

926 934

938

Transnational Support to Visually Impaired in Scientific University Courses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cristian Bernareggi, Barbara Hengstberger, and Valeria Brigatti

946

Chemical Workbench for Blind People – Accessing the Structure of Chemical Formula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Federsel Stephan and Klaus Miesenberger

953

E-Learning for Secondary School Teachers: Inclusive Science and Math Instruction for Students with Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . Robert L. Todd

961

Accessible Tourism Accessible Tourism Introduction to the Special Thematic Session . . . . . . . Franz P¨ uhretmair and Dimitrios Buhalis

969

How to Inform People with Reduced Mobility about Public Transport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Christian B¨ uhler, Helmut Heck, and Josef Becker

973

XXIV

Table of Contents

A Flexible Concept to Establish Accessibility Information in Tourism Web-Pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Franz P¨ uhretmair and Wolfram W¨ oß

981

(e-)Accessibility Research from the Perspective of the Tourism, Sport and Leisure Industries – Selected Project Results and Future Focus of the e-Motion Competence Centre . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Markus Lassnig, Mark Markus, Kerstin Matausch, Franz P¨ uhretmair, and Andreas Wagner

989

Smart Environments Smart Environments: Introduction to the Special Thematic Session . . . . . Gerhard Nussbaum

997

All the Way to Living Independently: Reflections on a Design Case . . . . . 1001 Peter den Brok, Ingrid Mulder, and Jan van den Berg A Living Lab for Ambient Assisted Living in the Municipality of Schwechat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1008 P. Panek and W.L. Zagler ENABLE – A View on User’s Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1016 Stefan Parker, Gerhard Nussbaum, Helmut Sonntag, Franz P¨ uhretmair, Veronika Williams, Rachel McCrindle, Christina Victor, David Oliver, Martin Maguire, Peter Mayer, Georg Edelmayer, and Paul Panek EasyControl – Universal Control System . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1024 ˇ ep´ Marcela Fejtov´ a, Petr Nov´ ak, and Olga Stˇ ankov´ a Eye, Me and the Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1030 Fangmin Shi, Alastair Gale, and Emilie Mollenbach Development of a Low Cost Base Station for Multimodal Home Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1034 Klaus-Hendrik Wolf, Arne Lohse, Michael Marschollek, and Reinhold Haux Distributed Accelerometers as a Main Component in Detecting Activities of Daily Living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1042 Josef Diermaier, Katharina Neyder, Franz Werner, Paul Panek, and Wolfgang L. Zagler A Smart Indoor Navigation Solution Based on Building Information Model and Google Android . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1050 Ferial Shayeganfar, Amin Anjomshoaa, and A Min Tjoa

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XXV

Developing a Sub Room Level Indoor Location System for Wide Scale Deployment in Assisted Living Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1057 Gerald Bauer and Paul Lukowicz Utilizing QR Code and Mobile Phones for Blinds and Visually Impaired People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1065 Hend S. Al-Khalifa Exploiting RFIDs and Tilt-Based Interaction for Mobile Museum Guides Accessible to Vision-Impaired Users . . . . . . . . . . . . . . . . . . . . . . . . . 1070 Giuseppe Ghiani, Barbara Leporini, Fabio Patern` o, and Carmen Santoro

Portable and Mobile Systems in Assistive Technology Portable and Mobile Systems in Assistive Technology: Introduction to the Special Thematic Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1078 R. Manduchi and J. Coughlan A Survey on the Use of Mobile Phones by Visually Impaired Persons in Japan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1081 Tetsuya Watanabe, Manabi Miyagi, Kazunori Minatani, and Hideji Nagaoka Mobility Impaired Pedestrians Are Not Cars: Requirements for the Annotation of Geographical Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1085 Thorsten V¨ olkel, Romina K¨ uhn, and Gerhard Weber People Helping Computers Helping People: Navigation for People with Mobility Problems by Sharing Accessibility Annotations . . . . . . . . . . . . . . 1093 Harald Holone and Gunnar Misund Inclusion of Accessibility Requirements in the Design of Electronic Guides for Museums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1101 Lourdes Moreno, Ma Carmen G´ alvez, Bel´en Ruiz, and Paloma Mart´ınez ODILIA – A Mobility Concept for the Visually Impaired . . . . . . . . . . . . . . 1109 Bernhard Mayerhofer, Bettina Pressl, and Manfred Wieser Cellphone Accessible Information Via Bluetooth Beaconing for the Visually Impaired . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1117 S. Bohonos, A. Lee, A. Malik, C. Thai, and R. Manduchi Crosswatch: A Camera Phone System for Orienting Visually Impaired Pedestrians at Traffic Intersections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1122 Volodymyr Ivanchenko, James Coughlan, and Huiying Shen

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Personal Mobile Assistant for Air Passengers with Disabilities (PMA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1129 Alireza Darvishy, Hans-Peter Hutter, Peter Fr¨ uh, Alexander Horvath, and Dominik Berner Search Strategies of Visually Impaired Persons Using a Camera Phone Wayfinding System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1135 R. Manduchi, J. Coughlan, and V. Ivanchenko Design of a Haptic Direction Indicator for Visually Impaired People in Emergency Situations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1141 Tomohiro Amemiya and Hisashi Sugiyama A New Cell Phone Remote Control for People with Visual Impairment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1145 Ryo Yoshida and Michiaki Yasumura

Skills vs. Abilities: Alternative Input and Communication Systems Skills vs. Abilities: Introduction to the Special Thematic Session . . . . . . . 1153 Grigori Evreinov A Character Input System Using Tooth-Touch Sound for Disabled People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1157 Koichi Kuzume An Eye Gaze Tracking System Using Customized User Profiles to Help Persons with Motor Challenges Access Computers . . . . . . . . . . . . . . . . . . . . 1161 Anaelis Sesin, Malek Adjouadi, Mercedes Cabrerizo, Melvin Ayala, and Armando Barreto Applicability of No-Hands Computer Input Devices for the Certificates for Microsoft Office Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1169 Wonsuk Choi, Dongwoo Lee, and Jongwhoa Na Assisting an Adolescent with Cerebral Palsy to Entry Text by Using the Chorded Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1177 Yun-Lung Lin, Ming-Chung Chen, Chih-Ching Yeh, Yao-Ming Yeh, and Hwa-Pey Wang Designing a Scanning On-Screen Keyboard for People with Severe Motor Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1184 Yun-Lung Lin, Ting-Fang Wu, Ming-Chung Chen, Yao-Ming Yeh, and Hwa-Pey Wang Evaluating the Hands-Free Mouse Control System: An Initial Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1188 Torsten Felzer and Rainer Nordmann

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GrooveWrite: A Multi-purpose Stylus-Based Text Entry Method . . . . . . . 1196 Khaldoun Al Faraj, Mustapha Mojahid, and Nadine Vigouroux Interaction between a Disabled Person and a Scanning Communication Aid: Towards an Automatic Adjustment of the Scanning Rate Adapted to the User . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1204 Souhir Ghedira, Pierre Pino, and Guy Bourhis Investigation of Calibration Techniques in Video Based Eye Tracking System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1208 Nerijus Ramanauskas, Gintautas Daunys, and Donatas Dervinis Text Entry System Based on a Minimal Scan Matrix for Severely Physically Handicapped People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1216 Julio Mir´ o and Pablo A. Bernabeu

People with Disabilities: Speech Therapy and Sound Applications Applications for Proximity Sensors in Music and Sound Performance . . . 1220 Ben P. Challis and Kate Challis EasyVoice: Breaking Barriers for People with Voice Disabilities . . . . . . . . 1228 Paulo A. Condado and Fernando G. Lobo An Experiment Using Personalised Multimedia Interfaces for Speech Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1236 Jennifer George and Paul Gnanayutham

People with Disabilities: Mobility and Care MOVEMENT – A Modular and Versatile Mobility Enhancement System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1244 Gernot Kronreif, Paul Panek, Alexander H¨ untemann, Ger Cremers, Andreas Hochgatterer, Martin F¨ urst, Peter Mayer, and Gert Jan Gelderblom BMI Based RHC Method for Wheelchair . . . . . . . . . . . . . . . . . . . . . . . . . . . 1250 Tohru Kawabe Modeling a Hands-Free Controlled Power Wheelchair . . . . . . . . . . . . . . . . . 1261 Ludmila C.A. Silva, Torsten Felzer, Geraldo G. Delgado Neto, Rainer Nordmann, and Franco G. Dedini Brake Control Assist on a Four-Castered Walker for Old People . . . . . . . . 1269 Tetsuya Hirotomi, Yasutomo Hosomi, and Hiroyuki Yano

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Table of Contents

Development of a Sit-to-Stand Assistance System . . . . . . . . . . . . . . . . . . . . 1277 Yoshiyuki Takahashi, Osamu Nitta, Kosuke Tomuro, and Takashi Komeda OLDES: Designing a Low-Cost, Easy-to-Use e-Care System Together with the Stakeholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1285 Christophe Ponsard, Mike Martin, Sarah Walsh, Susan Baines, S´ebastien Rousseaux, Giovanni Rinaldi, and Fulvio Tamburriello The Risk Factor in the Adaptation of Worksites in ICT-Related Jobs . . . 1293 Renzo Andrich, Giacomo Liverani, and Lucia Pigini Development of a Wearable Measurement System to Identify Characteristics in Human Gait - eSHOE - . . . . . . . . . . . . . . . . . . . . . . . . . . . 1301 Harald Jagos and Johannes Oberzaucher Experiences Using Mobile Phones as Patient-Terminal for Telemedical Home Care and Therapy Monitoring of Patients Suffering from Chronic Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1305 Matthias Pinsker, Karin Schindler, J¨ urgen Morak, Dieter Hayn, Peter Kastner, Michaela Riedl, Bernhard Ludvik, and G¨ unter Schreier

People with Disabilities: Service Provision Making an International Certificate Accessible . . . . . . . . . . . . . . . . . . . . . . . 1313 Denise Leahy and Dudley Dolan Effective Application of Paro; Seal Type Robots for Disabled People in According to Ideas of Occupational Therapists . . . . . . . . . . . . . . . . . . . . . . . 1321 Kaoru Inoue, Kazuyoshi Wada, and Yuko Ito Which Technology Do We Want? Ethical Considerations about Technical Aids and Assisting Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1325 Anne Venter, Gerlinde Renzelberg, J¨ urgen Homann, and Lars Bruhn Characteristics and Solutions of Digital Divide for People with Physical Impairments in Taiwan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1332 Yao-Ming Yeh, Ting-Fang Wu, Ling-Fu Meng, Ming-Chung Chen, Hwa-Pey Wang, Jung-Gen Wu, Chi-Nung Chu, Yun Lung Lin, and Chih-Ching Yeh Long-Time Effect from Deprived Communication, Information and Orientation/Mobility in Individuals with Acquired Dual Impairment and the Need for ICT-Aids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1340 Michael Cyrus and Frank Lunde Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1345

Understanding User Centred Design (UCD) for People with Special Needs Harold Thimbleby Future Interaction Technology Laboratory (FIT Lab), University of Swansea, Wales [email protected]

Abstract. “User centred design” (UCD) has become a central, largely unquestioned, tenet of good practice for the design of interactive systems. With the increasing recognition of the importance of special needs in influencing design, UCD needs to be re-examined, in particular to be clear about the difference between using its methods, which may not suit special needs, and achieving its objectives. This paper introduces a simple two-category classification of special needs, to which UCD applies very differently and which are heavily affected by developments in technology; in other words, the role of UCD, particularly with respect to special needs, will continue to change and demand close scrutiny.

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Introduction

User Centred Design (UCD) is one of the essential concepts in Human Computer Interaction (HCI), interaction design, usability engineering, interaction programming — and all the other fields that have designing effective interactive systems as their goal. User centred design is design that is based around the real and actual requirements of users, and typically involves task analysis, prototype development with users, evaluation, and iterative design. Designers unaware of UCD typically argue they do not need user centred methods: they can use their systems, users don’t complain . . . what’s the point? Users may not complain for all sorts of reasons, for example that the user interface defects are too complex for them to understand, and their managers or other pressures to achieve mean that they are more interested in working around problems and succeeding than in giving designers feedback. UCD clearly has a cost, and if the benefits are minor, then there is no business case to do it. It is no wonder, then, that there have been many forceful arguments for UCD arguing against these attitudes. Classic arguments in the literature include Landauer’s The Trouble with Computers [21], Gould and Lewis’s 1983 paper “Designing for usability—key principles and what designers think” [9,10], and Draper and Norman’s User Centred System Design [25]. However, the arguments for user centred design emerged from the 1970s historical context and, in particular, as a reaction against what might be called technology centred design (TCD?) as it then was — and as it was then failing. These high-profile, persuasive arguments, and many others, established UCD as epitomising the field. ISO standards, such as ISO K. Miesenberger et al. (Eds.): ICCHP 2008, LNCS 5105, pp. 1–17, 2008. c Springer-Verlag Berlin Heidelberg 2008 

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Table 1. Representative changes affecting UCD since the 1970s. There are many more factors we do not have space to cover: changing demographics (many more elderly users); social interaction (web 2.0, massively multi-player games); physicality; complex consumer devices (e.g., home cinema, sewing machines); location-aware (GPS etc); games consoles; mobile phones; point-of-sale (POS) devices; iPod; legal requirements . . . and so on. Not all changes are positive. Change since 1970s Rise of consumerism Appropriation

Standardised office systems Standardised business processes Complexity of design World wide web Users with special needs

Ubiquitous computing Customer loyalty

1970s Employees required to use bespoke systems Computers restricted to work environments, and had to be used for work in standardised ways Systems had to be designed for specific users new to computers Every business works differently, typically using ad hoc paper-based systems UCD could evaluate typical systems No international or universally available resources Few employees had special needs; even fewer used computers; users were homogeneous All computers (or terminals) are desktop Users do not buy or own interactive systems

Accessibility software

No allowances for special needs

Change in usability

Usability is effectiveness, efficiency and satisfaction (ISO 9241)

Public interfaces

No public interfaces

2000s Consumers buy what devices they like Gadgets appropriated by users for tasks they were not designed for (e.g., phone-as-a-torch; SMS) Employees have transferable skills Since office and other systems (e.g., email, web, mobile phones) are well known, they define business practice Some systems too complex too rely on user evaluation Huge resources with standardised user interfaces (browsers) User needs are very diverse; UCD per user is very costly Many physical forms, wireless, etc available Making systems different makes users less able to use competing products Standardised accessibility software (e.g., text to speech; magnification) widely available Usability includes empowerment, enjoyment, experience, enchantment, care, socialisation Walk-up and use interfaces everywhere

13407: Human-centred design processes for interactive systems have established UCD as a definitive standard. There is surprisingly little hard evidence that UCD works reliably or as well as is generally supposed; for example, in a panel session at the ACM CHI conference as recently as 2006 [27] the question debated was whether think aloud (a widely used UCD technique) works. The panel pointed out that most arguments for the efficacy of UCD methods are based on usability work where the aim is to improve a system, rather than to test any method, so the evaluation of the method will be confounded: the experiments are really about usability, not usability methods. That is, the purpose of usability work is to improve a system, then empirical work may just deliver what people want, namely an improved system, rather than a tested UCD method. When looked at more closely there is very little experimental study specifically supporting the use of UCD methods, though there is an enormous literature on improving systems!

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When there is experimental evidence in support of UCD, great care must be taken to interpret the results: for example, UCD methods to reduce design defects are typically very different from UCD methods aimed at improving the user experience, and in any case many “UCD” experiments might better be understood as psychology experiments aiming to understand human behaviour rather than design processes as such. In particular, generalising from methods that have been shown to work with normal users is unlikely to be reliable with special needs users yet, ironically, special needs users would generally benefit even more than normal users by successful UCD work. Almost all UCD studies (or development using UCD methods) has been performed on “normal” users, and indeed often undergraduate students who, for instance, generally won’t have cognitive problems. Taking account of special needs in UCD does matter: a study of think aloud with blind users showed it had unexpected problems [6]. Ironically, while remote evaluation promises access to larger pools of users — and hence the opportunity to recruit adequate numbers of test subjects with specific special needs — studies show that special precautions are required [26] (a paper which is to be recommended for its principles). In short words: UCD is certainly not a fixed set of techniques that work reliably, regardless of the user population. These issues are all before we start questioning the quality of the science behind UCD. The Gray and Salzman papers [11,12] discredited — in some people’s eyes — the quality of many usability experiments; Cairns [4] questions the use of statistics; and Chen [7] questions fundamental psychology assumptions — he argues it is an artifact. On the other hand, science is a progression towards consensus, and it does not have to be perfect all the way; the point of papers is not to be perfect unassailable science, but to argue that certain ideas are worth holding on to. And one can argue in many ways; science is just one way, statistics another, and starting from human values another. UCD is about respecting users, and it needs no science to argue the value of that. We need first to see why UCD makes sense, rather than trying to test it and showing it does when it does (if it does). For the more that UCD makes sense, the less we need to rely on experiments that are anyway very hard to do in such a complex area. For the more UCD makes sense, the more able we as designers and agents of change can adapt it to the needs of particular cases. This is a pertinent point of view for design for special needs. Instead of relying on arguments for UCD, instead it is more appropriate to say UCD is a value: we believe that respecting users and their diversity is important, and moreover that we do not begin to understand the needs of users until we explore with them what these needs are. “Focus early on users.” If we do not take account of accessibility and inclusion, we are by default excluding some users. Instead, we believe UCD is a self-evident good and that is sufficient to take it seriously. It would be nice if there was some rigorous experiment supporting that view, but the complexity of real life — to say nothing of our willingness to believe even the most tenuous experiments supporting UCD because we want to believe them! — means that this is an unlikely dream. In the context of this

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paper, rigorous experiments supporting UCD in the special needs domain are going to be even more problematic (consider experimental controls, statistical power are all compromised, to say nothing of more complex ethical clearance issues). Instead, we need to understand what UCD is about and what it tries to achieve, rather than ask for hard evidence. This paper will argue that UCD, while remaining a self-evident good, is no longer a universal panacea to user interface design. Rather, we need to understand what UCD aims to achieve, and then to work out how to achieve those (or better) goals for the problems in hand. There can be nothing more ironic, surely, that saying “let’s be user centred,” and then deploying a standard UCD technique regardless of the specific users and tasks and expecting UCD to deliver design value. There are several reasons why UCD should no longer be given the same status as it justly deserved in the 1970s: the rise of consumerism, the increased complexity of user interfaces, the increased familiarity of users with computers, and the increasingly important role of users with special needs. . . , and many other reasons, as illustrated in table 1. (In table 1 and throughout this paper, we use “1970s” as an informal but convenient label for a style and approach to design that might be said to have peaked during the 1970s period.) What is very clear from table 1 is that the role of interactive systems has changed enormously since UCD was first proposed; moreover, some of the assumptions that UCD entails, such as the effectiveness of evaluation are called into question because the world has changed. UCD will, of course, change further in the future: the emphasis is moving from desktop to mobile, from mobile to ubiquitous, from ubiquitous to embedded. Similarly, the underlying concept of “usability” is moving from productivity to satisfaction. In the 1970s, evaluation of a pool of users would provide statistically useful data cost-effectively — for example, an hour’s evaluation with 10 users would provide high quality information to guide iterative development of a design. Classic papers such as Nielsen and Landauer’s mathematical model of finding usability problems [24], and many UCD methodologies such as cognitive walkthrough [34], think aloud [6,27], and scenarios [28] emerged around this time. However users with special needs have diverse requirements, as for instance there are fewer similarities between users, and statistical power of evaluation studies with one user is nonsense. More importantly, in the 1970s environment, the effort required for a UCD study could be shared amongst many users, whereas design with special needs in mind may put all the evaluation effort onto few users or even a single user. In some cases, the special needs of those users may mean that sufficient data is too costly to obtain: they may be too exhausted to continue, they may have limited attention, their carers have additional needs, and they may resist cooperating or wish to make the experience counterproductively more exciting (say, if they have a low mental age). Paradoxically, despite such obvious problems with UCD, special needs users (together with their friends and carers) have more to gain from well-designed user interfaces.

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Not only is UCD harder with designing for single users, but modern interactive devices are much more complex than typical 1970s systems that were the staple of UCD. A “5 user” heuristic analysis will not have time to explore enough of a system to identify design issues. Thimbleby [31] reports a simple device where typical UCD would take months to have 50% chance of finding a crucial error. Special needs users may not have that time or attention available, and as there is more variance between special needs users, the Nielsen and Landauer formulæ are too optimistic.

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Objectives of UCD

The prime objective of UCD is to improve the usability of delivered interactive systems, and while the definition of “usability” is changing, and can change for different applications (e.g., compare games, where usability is about fun, flow and engagement, with medical devices, where usability is about reducing untoward clinical incidents), the objective breaks down into uncontentious subsidiary objectives: Define and prioritise usability values with users. — otherwise known as early focus on users. Surely the purpose of doing anything is to help people (perhaps sometimes just ourselves)? The first step is to identify who these people, the users, are and how they might best be helped — what their values are. UCD takes it for granted that we do not know a priori how best to help users without their participation. Match task requirements to design. What is wanted and what can be achieved (given the timescales for delivery, limited resources, politics, and so forth) are rarely the same! In general, the design should realise the realistic requirements of the users’ tasks, baring in mind that the task that can actually be supported by the system may not be the same as what the users would ideally like. Remove defects from the design, and from the requirements. It is very unlikely that a design will work well to start with. UCD emphasises that designs have defects and that they should be found. Less often emphasised is that requirements have defects, partly because users did not understand how a working system would change their behaviour. UCD realises that there are different sorts of defects and different costs in identifying them. So-called “killer defects” should be found efficiently and quickly. Test against usability criteria. Defects are things wrong with the design; usability is about how the design supports the usability criteria. For example, can tasks be completed within appropriate times? Iterate design to continuously improve. Typically the previous stages of UCD identify issues that can be fixed, however fixing them creates a new system with new issues. Realistically, iteration is tightly interleaved with evaluation in a process of continual improvement — this aims to avoid evaluating parts of a design that may be modified during iteration.

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In short, make usability a goal of design and find ways to achieve it, given the reality of an imperfect world where neither requirements nor delivered systems are ideal. UCD really requires delivered systems to be continuously improved through further user evaluation and feedback to designers; many business models rely on this, continually producing new versions of their systems. Seen like this, UCD as a concept applies equally to special needs and to “average” users. As will become clear, UCD has to be achieved by using methods, which have costs, and we must not confuse the methods with the goals. A caricature would be: “did you use UCD?” – “yes, I used think aloud and a user experience questionnaire with Lickert scales and a χ2 test . . . ” – “were any of your users dyslexic?” – “does it matter?” In particular, we will see that UCD has costs on the user, and when the user is special needs these costs cannot be spread around a large community of homogeneous users, and may thus be disproportionate to the assumed gains of the conventional UCD effort.

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Why UCD Was Invented Out of the 1970s

Again, taking “1970s” as a rough category, prior to the 1970s there were three sorts of user. There were people with hands-on use of the computers; these were usually called “operators.” There were people who programmed computers; called “programmers.” And, thirdly, there were the people who thought of themselves as “users,” but who worked through the operators rather than using the computers directly themselves. Operators were highly trained. Often, users were the operators and programmers — with the consequence that designers and users had the same conceptual models. Finally, the nature of the technology meant that most users had very little real interaction with the computer: a typical task might take a day to work through. Computers tended to be used for “batch” tasks like payroll, where what might be called the “interaction cycle” took a month, and most users did nothing explicit to get results from the system. As the 1970s progressed, the power of computers increased and more users got direct hands-on experience with increasingly fast turnaround times. The most prominent style of interactive system was the mainframe computer (or minicomputer) connected to many terminals or user workstations. Software was written for the mainframe, and ran identically on each terminal. Typically, a business would tender for their processes to be automated, and a software company would write new software to do so. Most of the programmers who wrote the software would be new to the task that was to be automated, and typically they would write software to do what managers wanted — managers, after all, were their clients, not the end users — rather than to support what users were actually doing. Typical early-1970s tasks were word processing, airline reservation, air traffic control, stock control: cases where there were few designers working for many users — and users mostly with very different social backgrounds to the designers. If the software company was lucky, they would find more businesses with similar processes, and they would sell their software into these businesses. Now the connection between the software design and the users was even more tenuous!

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Most designers have considerable development experience. Inevitably, much of their experience was based on designing systems that they used. Most computer science courses today continue this: most education assumes students are individuals and are assessed alone. When people design systems for themselves (or systems for assessment that only they will use, even if the assessment asks for systems designed for other people), the designer is the user, and therefore — notwithstanding bugs in the system — the user model is the system model. The designers learn, if not correctly, that there is no need for UCD. The key idea — the beginnings of UCD — was captured by Hansen’s 1971 slogan “know the user” [13], which UCD takes to mean two things: identify the user, and identify what they want. This can be refined further: what people really want may not be what they say they want, and what people want will change as soon as they get something, and there are conflicting types of user — for example, the employer or carer may have wants that are different form the actual users. Knowing the user isn’t just knowing about the user, it is knowing who the user is; the client who pays for the design work is rarely the user who benefits most directly from a successful system. “Knowing the user” is often unpacked as knowing the user’s model. The user model as an idea was not popularised until Newman and Sproull’s revised edition of their Principles of Interactive Computer Graphics [23] the then leading, and almost only, graphics textbook had a chapter on user interface design that discussed the user model at length. The user model is supposed to be how the user conceptualises their work practices. Since designers are not users, and have often had a training that emphasised technological expertise, in many cases the designer’s conceptualisation of the user model would be inaccurate. Furthermore, programming is hard and even if a designer had a good conceptualisation of the user model, they would be unlikely to realise a computer program that matched the user model. The first problem is addressed by studying the user’s tasks, and thus constructing an explicit, reality-based user model. The second problem is addressed by iterative design: build a system then see how well it works, then use the evaluation to improve it. This is basically Gould and Lewis’s advice: early focus on users and tasks; empirical measurement of product usage; iterative product design. The “user model,” while a pithy phrase with an intuitive meaning and an apparently straightforward and central role in UCD, begs many questions. What exactly is a user model? Arguably, that question led to two different research programs: the model human processor (Card, Moran & Newell [5]), and explicit user models such as ACT/R (Anderson [1]). Neither have found wide use in interaction design, and neither have been used for special needs work. A very important role for UCD is to decide what the goals of a design are, and to make these goals explicit, otherwise the design will optimise unstated (and possibly unknown) goals. In the 1970s, the general assumption was that usability was to be equated with productivity or effectiveness — but effectiveness for whom, though? In the 1970s effectiveness was usually defined in business or employment terms. Now, usability is defined much more in a user-centric

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Task analysis

Use evaluation

Formal specification

Implementation

Fig. 1. Iterative design requires going around the design cycle, here shown schematically, more than once, otherwise there is no iteration! Therefore every step, not just the obviously UCD steps, are necessary for usability

way: what is the user experience (UX), what do they want? In the case of special needs UCD, it is crucial to decide whether the purpose of the design is rehabilitation, augmentation, fun, education, socialisation, persuasion (e.g., to take medicines), and so on; these are very different goals. In the 1970s, it would be clear that the purpose of UCD for a special needs user was to make their work more productive; today, it is recognised that there are many other valid goals of design, and, moreover, that the goals are not mutually compatible. For example, enabling a worker to be efficient in the work environment may be at odds with fun or socialisation, and there is clearly a difference between a user interface that is efficient and a user who is efficient — one requires conventional UCD, the other requires persuasive techniques [8], and this “conflict” becomes apparent in issues like security (e.g., users need to be persuaded to use passwords effectively). However, a user may decide they wish to increase their earning potential or selfesteem by working more productively — so even “work goals” may be aligned to user goals. In the 1970s, few system implementers were trained in design or HCI, and many because of their ignorance of UCD may have thought they knew enough to design well [19]. “Hey it works well for me!” Worse, without formal evaluation (which UCD assumes), they would be influenced by the survivor effect: when implementers or designers hear from current users, these must be users who have survived using their system. The ones that failed no longer use the system, so the designers get a biassed sample, which appears to confirm their success at designing good systems.

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Why UCD Is Not Sufficient Now

Central to UCD is of course working with the user. The user performs tasks and the performance (speed, enjoyment, error rate and so forth) assessed; errors and impasses in the design are identified — for example, a think aloud protocol may have the user saying “I don’t know what to do now,” and this point identifies an opportunity for the design to be clearer. Unfortunately, there is a tradeoff: – If the system is complex, the rate at which UCD identifies worthwhile improvements to design is too low, particularly if there are too few users available to work with the system. A complex system means that UCD

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insights may not be reliable; they may not generalise across the design — parts of the design may have escaped scrutiny. This means the cost to the designer of UCD is too high. – If the system is simple, it is likely the design is simple because the user has physical or cognitive capacity problems. This means the cost to the user of UCD is higher. Obviously this tradeoff is a gross simplification of the complexity of real users and real design, but it suggests that there is a “sweet spot” where a system is not too complex for UCD to be reliable and the user capable enough to be able to provide sufficient data. The position of the sweet spot varies with the user. In other words, UCD is not always best — or, certainly, the cost/benefit tradeoffs that are implicit in most UCD (e.g., in Nielsen’s satisficing cut-off of 5 users [24] is probably too high) need to be carefully reconsidered when the up-front costs to the users is higher. A more detailed look at interaction design (H. Thimbleby & W. Thimbleby [33]) shows that design is not just concerned with the user; the program has its own problems too! A successful design needs both sides to work (and, of course, to work together). This requires competent software engineering, and it may involve solutions such as better user training where the device cannot be configured to match the user’s requirements. Thimbleby & Thimbleby introduced the terms “externalist” (the external-to-device side, the user and environment, the UCD) and “internalist” (the internal-to-device side, the hardware, the program, the SE) to help emphasise that neither is sufficient but both are necessary; see figure 1. One could do internal work that contributes to a good design but with no UCD — and, conversely, one could do good UCD work that contributes to a good design but involving no internal work.

5

Why UCD Is Not necessary Now

Many (such as Gould and Lewis [9,10]) would argue that UCD is essential. UCD can often improve designs, but sometimes the cost is out of proportion to the benefits, particularly when the cost to the user cannot be spread between more than one user. It may be far easier for the user to choose a different product than to do UCD on a developing product. Interestingly, Gould & Lewis do not justify UCD (or, more specifically, their four principles): they take them for granted: their classic paper is not evidence for the principles, but evidence about how little they were known by practicing designers. Despite the rational arguments for (and not entirely for) UCD outlined above which expose its assumptions, many would defend UCD uncritically. They may be right (and this paper wrong); they may be right but subject to unspoken assumptions; or, possibly, they may be certain but misguided. The latter is a significant possibility. UCD is hard, both for the users and for the designers. People who have gone through a UCD experience are likely to find design insights, but after hard work. Cognitive dissonance predicts [29] that they are then

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likely to justify the UCD against the suggestion that better results could have been obtained more easily. Similarly, the users involved in the UCD exercise may prefer the device because they themselves put a lot of work into its UCD, whether the device is “objectively” improved or not. Of course, if a user thinks they prefer a design that is not objectively better, then thinking they prefer it means they actually prefer it. We could distinguish between ideal UCD and realistic business UCD. In the ideal UCD case, eventually the user gets a very nice product that does what they want; the problem for business is that this takes a long time to recover development costs. Instead, a knowingly-imperfect system is sold, and then UCD leads not to iterative design but to new products the user pays for. This creates market churn, and most everybody is happy: users get nearly usable systems faster, business has an income stream, but the environment suffers as systems become obsolete rather than updated through actual iterative design. One of the issues is that a business (or business sector) will hold a portfolio of products and, over time, they will drop ones that are too costly to improve; these become not just obsolete but unavailable. In this business model, the goals of UCD are sort-of satisfied, and users pay for it, and the longer they stay in the market paying for improvements the better the devices become. Some people have old mobile phones, because for them the cost/benefit of newer, improved models is insufficient to upgrade. Unfortunately, special needs users are never a large part of a market particularly for devices that have low cost because they are massively mass produced (like mobile phones). Thus the business section may drop a model or style that some users would prefer to stay with. For example, as mobile phones have become smaller and lighter, which the mass market prefers (which statistically speaking UCD prefers), users who require large keys and large displays (for legibility) lose out.

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The Reality of Bad Design

Heathrow’s Terminal 5, which failed immediately after it opened, was user tested, but users were involved at such a late stage that the timetable for opening could not be modified [35]. Or consider the Abbott AIM infusion pump, a device involved in a fatal drug overdose, with such a poor user interface that a very brief UCD study identified many flaws [15]: but the device is in production, and changing it would involve expensive recalls, retraining, and the possibility of incompatible devices (original and improved) left in use and operators making transfer errors. The root cause analysis of the fatality [15] suggested that the hospital should undertake human factors studies (i.e., UCD without the designers!) itself, to choose which devices to procure. This view stems from the authors of the report apparently believing that when a device behaves as designed it is correct, though as they acknowledge that the study showed problems in use, they blame not the design (or the design process) but the choice of device, the hospital training, and so on. If the hospital had procured the device after its own user studies, it

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would have had one that was easier to use. There is no moral case to be made that the manufacturers need not have done adequate UCD themselves (in fact, the design defects, so easily uncovered in a brief study, are horrific), but it is an argument that a successful business case can be made for not doing UCD if official reports suggest users should do them for you. In a better world, an informed manufacturer would identify usability criteria and the performance of their products against those criteria — this would be a direct output of in-house UCD. Thus users (or procurers) could then choose in an informed way between various products against their own usability and other performance criteria.

7

The Cost of Iterative Design

The purpose of UCD is to improve design, but the very act of doing a UCD study involves the user working with the previous design. The more data is obtained about the design that is supposed to be being improved, the more the user (or users) are learning about the obsolete design. For a mass produced device (like a typical mobile phone) the number of users involved in the UCD study is a tiny proportion of the user population of the improved device, so UCD is worthwhile: most people get a better deal. But in user interfaces for special needs users, there are very few — often, just one — user and the benefits are much less obvious. If the user is cognitively impaired, the effort of working with the prototype may mean that improving the design would cause transfer errors, transferring the prior training on the prototype to the modified design. Ironically it is likely that the most deliberate and conscious activities during evaluation are around the worst parts of the design exploration, and hence the most effort was put in by the user into the very parts that are likely to be changed. If the UCD studies take a long time, perhaps the best improvement is no improvement at all! One solution to the cost of revision problem is to perform UCD on sketch prototypes [3], so that no or limited learning can really take place, but the designer can still get useful evaluation.

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The UCD Slogan May Be Counter-Productive Today

Interactive system design is not just about designing (and deploying) effective interactive systems, but it is also about advancing the field: innovating, spreading best practice, and developing the expertise and skill set of practitioners and researchers in the field. Publication is one of the standard ways of disseminating advances; to the extent that the community insists that a “proper” publication or contribution to knowledge must include UCD, then some valid contributions will not make it through the refereeing process. In an ideal world, one might do everything perfectly, but — and particularly when working with special needs users — doing UCD as well as innovating may be one step too much for a typical contribution. Furthermore, if UCD is to be done as well, then a publication may

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take more than a year to prepare, and then it misses the natural annual cycle of publication in conferences. UCD (evaluation, statistics, controlled experiments, and so forth) are desirable in any paper claiming to make advances to design knowledge, but they are only one form of arguing validity. Here is an example of this problem, and how it detrimentally affects the wider user (and research) community. Beveridge and Crerar [2] reported on a user interface designed for stroke victims, which had been evaluated on just three aphasics. At the time, they had been unsuccessful in getting continuation funding to develop their work because referees wanted a user study with more subjects. It is of course very hard to find other stroke victims with comparable issues for which the same user interface innovations would be relevant. That was 1999; today, with the accessibility of the web, it is possible that more users could have been recruited: the world as a whole probably has thousands of users who could benefit.

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Two Sorts of Special Needs: Programmable and Unprogrammable

There are two sorts of special needs in users, that can be addressed by very different solutions. Computers are programmable and can meet any “virtualisable” requirement (and in the future, with nanotechnology and other developments, not just virtual but any physical requirements too). However programmability comes at the cost of increased complexity (whether or not it is easy to use). Thus the two sorts of special needs are those that can be handled adequately by programmability and those that cannot. This is not a classification of special needs as such, but a classification of special needs and systems together, as the following contrasting examples make clear: – An example of a special need that is handled well by programmability is a patient in a hospital, for instance in an intensive care unit. The patient has very specialised needs, but the complexity of the system they are using (e.g., an infusion pump) is managed by trained clinicians: exactly the same system can be used for many different patients. – An example of special needs not handled well by the flexibility of programming is a user with dementia, or a user in a wheelchair trying to use an “automatic” toilet — without a carer, both users have to handle the complexity of the programmable user interface. Some special needs are moving from one sort to the other, as technology develops. Thus although mobile phones are getting smaller and therefore harder to use for some, they are also getting more programmable: programs could change a phone to have large buttons and large writing — and, crucially, the incremental cost of programs (their manufacture and sale) is negligible compared to the hardware: special needs users in this category will benefit enormously. (Apple’s iPhone is an example.)

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“Programmability” is a spectrum; it can range from completely free device programmability, where the programmer can achieve anything the device is capable of; user programmable, where the programmability is restricted (and perhaps therefore safer); configurable, or set by the user choosing from a limited set of choices; or adaptive, where the device learns and modifies its behaviour itself (e.g., [32]). The spectrum therefore covers reprogramming that might involve taking the device or system to a specialist (e.g., to change the firmware), to something that happens automatically without explicit intervention. Note, of course, that for some users, adaptibility may be unwanted: its consistency over time may be important.

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Best Practice. . .

UCD is not an automatic way to improve the user experience, particularly when the user has special needs (or the user is a carer of a person with special needs). The earlier parts of this paper explored the rationale for UCD, and has shown how the design environment has moved on from the classic 1970s assumptions and will continue to develop. UCD is still relevant today, but best practice must not use it unthinkingly. It is a tool for better design, and it is not the only tool in the box. The conference series of Computers Helping People with Special Needs is an excellent resource [16], illustrating the value and diversity of the field. A short paper cannot capture “best practice” in just a few words, but given the discussion has been about UCD and the reader of this paper can be confidently assumed to have a significant background in design practice and its ( vast ) literature (not all of it sympathetic, e.g., [36]), the following points may be flagged as important components of contemporary best practice: Understand how to think about UCD. The usual way of thinking about UCD at a higher-level is to view it from the maturity lifecycle perspective [18]: people (or organisations) don’t have problems with usability (because they don’t know about it) . . . through to UCD is properly embedded in the organisation (or in a designer’s repertoire) as a key part of development and evaluation. While the maturity model is helpful, it tends to take “UCD” as a fixture, whereas this paper has argued that UCD itself has to be understood, not just used as if all users and tasks were essentially the same and all amenable to the same bag of techniques: we can always improve processes, and while maturity models focus on the use of given processes, such as using UCD, the activities (here, UCD) themselves can be improved. Get involved with real users as soon as possible. The key lesson of UCD is iterative design is essential to make systems better — but the later UCD is engaged, the more investment there has been in possibly suboptimal design. The earlier UCD can be used, the more flexibly and usefully designers can respond to the UCD insights. Thus, use field research, sketches, nonfunctional prototypes, focus groups and other methods that do not rely on things “working.” Holzinger gives a good example of the issues and value of

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working with paper prototypes with elderly users for the design of a mobile questionairre [14]. Use indirect methods. (early lifecycle methods) It seems tautologous the UCD involves users, but it need not use them directly, and therefore the costs of UCD need not be borne by the final users themselves. For example, scenarios can be developed and these portray very effectively to designers even though the scenarios may have been created with other users (for example, there are many available scenarios of elderly users, and these can also be used to help inform new designs — thus reducing the impact of UCD on users). Book, films, digital stories, forum theatre and many other techniques play a similar role, in addition to the standard repertoire from UCD: expert walkthrough, heuristic evaluation, guideline checklists. Use analytic methods. Much of the work conventionally done with users can be done analytically, whether on the human side (e.g., using a simple Fitts Law analysis [22] to cognitively sophisticated simulations such as CogTool [17]), on the system side [30], or both [20]. Use best practice software engineering. A significant cost in UCD is defect elimination. Many defects are a result of poor programming practice, and can be avoided in principle. Test and evaluate with simulations. Simulated users can be used to obtain much use data that can be used in UCD; moreover, defining the simulated user (robot or virtual user) requires studying the users and tasks carefully, and this may obtain useful explicit design insights. A single simulated user can be used repeatedly in many UCD trials, thus saving effort for the real human users. Simulated users can range from purely random [30], based on large survey data, to sophisticated models, such as those based on realistic cognitive models like ACT/R [30]. Make a range of well-defined products/prototypes. If users can choose between products, then they can choose those that best suit their needs. This assumes that manufacturers are honest about their products’ capabilities, and (particularly for special needs users) it assumes that manufacturers allow their products to be trialled. Many devices can be simulated on the world wide web; these should be as faithful to the real device as possible (which doesn’t readily happen [31]); many devices could be semi-realistically simulated on PDAs or other handheld devices, for more realistic assessment. Make systems programmable, adaptable or end user programmable. You either have to make a system good enough first time or adaptable. It does not matter whether a device is programmable by specialists (as opposed to the manufacturer), by the user, or is self-programmable (otherwise called “adaptive”) or controlled by “preferences” the user (or carer) defines — but making a device programmable means that the user or user community or even enthusiasts can adapt the device to specific needs of users. As mentioned above, this list is not exhaustive. For authoritative ideas, see the relevant ISO standards, such as 9126, 9241, 13407, 18529 and TR 16982.

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15

Conclusions

UCD is important but is often confused for using the conventional methods that achieve “UCD” for normal users. When users have special needs, they are more diverse and the costs of performing UCD increases dramatically, particularly for the intended end-users. Ironically, for some special needs, the very act of UCD may train the user (or carer) or focus their expectations in a way that will limit the (conventional) scope of UCD and iterative design. The standard tradeoffs (e.g., five users for a heuristic evaluation) are all called into question when the cost/benefits are so different, and when the cost/benefits cannot be amortised across a large population of similar users. The nature and role of UCD has changed considerably since it was first introduced in the 1970s period, and it continues to change. In particular there is an increasingly clear distinction between user needs that can be met through programmable and non-programmable methods on particular systems: this is a sufficiently clear distinction for it to be used in classifying special needs and tasks for the purposes of interactive system design. An example is a programmable mobile phone where the typography can be controlled by graphics programming so visual problems might be worked around; on the other hand, graphics programming cannot compensate for physical keys being too small or not providing adequate tactile feedback — on different hardware, or for different tasks, what special needs can be “programmed around” will be different. The purpose of this paper has been to encourage the designer, particularly the special needs designer, to achieve the aims of UCD without unthinkingly simply using its current methods, thinking the means justify the ends. The purpose of UCD is to respect users, and to find ways to make that a practical possibility during the design process and hence to obtain benefits for everyone.

References 1. Anderson, J.R., Lebiere, C.: The Atomic Components of Thought. Lawrence Erlbaum Associates, Mahwah (1998) 2. Beveridge, M., Crerar, A.: A multimedia presentation system for the remediation of sentence processing deficits. In: Proceedings of INTERACT 1999, pp. 272–280 (1999) 3. Buxton, B.: Sketching the user experience. Morgan Kaufmann, San Francisco (2007) 4. Cairns, P.: HCI. . . not as it should be: Inferential statistics in HCI research. In: Ball, L.J., Sasse, M.A., Sas, C. (eds.) HCI 2007, vol. 1, pp. 195–201 (2007) 5. Card, S.K., Moran, T.P., Newell, A.: The Psychology of Human-Computer Interaction. Lawrence Erlbaum Associates, Hillsdale (1983) 6. Chandrashekar, S., Stockman, T., Fels, D., Benedyk, R.: Using think aloud protocol with blind users: A case for inclusive usability evaluation methods. In: Assets 2006: Proceedings of the 8th international ACM SIGACCESS conference on Computers and Accessibility, pp. 251–252. ACM, New York (2006) 7. Chen, M.K.: Rationalization and cognitive dissonance: Do choices affect or reflect preferences? Technical report, Yale School of Management (2008)

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8. Fogg, B.J.: Persuasive technology. Morgan Kaufmann, San Francisco (2003) 9. Gould, J.D., Lewis, C.: Designing for usability—key principles and what designers think. In: CHI 1983: Proceedings of the SIGCHI conference on Human Factors in Computing Systems, pp. 50–53. ACM, New York (1983) 10. Gould, J.D., Lewis, C.: Designing for usability: Key principles and what designers think. Communications of the ACM 28(3), 300–311 (1985) 11. Gray, W.D., Salzman, M.C.: Damaged merchandise? A review of experiments that compare usability evaluation methods. Human-Computer Interaction 13(3), 203– 261 (1998) 12. Gray, W.D., Salzman, M.C.: Repairing damaged merchandise: A rejoinder. HumanComputer Interaction 13(3), 325–335 (1998) 13. Hansen, W.J.: User engineering principles for interactive systems. In: AFIPS Conference Proceedings, vol. 39, pp. 523–532 (1971) 14. Holzinger, A., Sammer, P., Hofmann-Wellenhof, R.: Mobile computer in medicine: Designing mobile questionairres for elderly and partially sighted people. In: Miesenberger, K., Klaus, J., Zagler, W., Karshmer, A.I. (eds.) ICCHP 2006. LNCS, vol. 4061, pp. 732–739. Springer, Heidelberg (2006) 15. Institute for Safe Medication Practice Canada. Fluorouracil Incident Root Cause Analysis (2007), www.cancerboard.ab.ca/NR/rdonlyres/ D92D86F9-9880-4D8A-819C-281231CA2A38/0/IncidentReportUE.pdf 16. International conference on computers helping people with special needs conference series. LNCS, vol. 2398, 3118, 4061, etc. Springer, Heidelberg (2002) 17. John, B.E., Salvucci, D.D.: Multi-purpose prototypes for assessing user interfaces in pervasive computing systems. IEEE Pervasive Computing 4(4), 27–34 (2005) 18. Jokela, T., Lalli, T.: Usability and CMMI: Does a higher maturity level in product development mean better usability? In: CHI 2003 extended abstracts on Human factors in computing systems, pp. 1010–1011. ACM, New York (2003) 19. Kruger, J., Dunning, D.: Unskilled and unaware of it: How difficulties in recognizing one’s own incompetence lead to inflated self-assessments. Journal of Personality and Social Psychology 77, 1121–1134 (1999) 20. Lacaze, X., Palanque, P., Navarre, D., Bastide, R.: Performance evaluation as a tool for quantitative assessment of complexity of interactive systems. In: Proceedings of the 9th International Workshop on Interactive Systems, Design, Specification, and Verification (DSVIS), vol. 2545, pp. 208–222. Springer, Heidelberg (2002) 21. Landauer, T.: The Trouble with Computers. MIT Press, Cambridge (1995) 22. MacKenzie, I.S.: Movement time prediction in human-computer interfaces. In: Baecker, R.M., Buxton, W.A.S., Grudin, J., Greenberg, S. (eds.) Readings in human-computer interaction, pp. 483–493. Kaufmann, San Francisco (1995) 23. Newman, W., Sproull, R.: Principles of Interactive Computer Graphics, 2nd edn. Mcgraw-Hill, New York (1979) 24. Nielsen, J.: Finding usability problems through heuristic evaluation. In: Proceedings ACM CHI 1992, pp. 373–380 (1992) 25. Norman, D.A., Draper, S.W.: User Centered System Design; New Perspectives on Human-Computer Interaction. Lawrence Erlbaum Associates, Inc., Mahwah (1986) 26. Petrie, H., Hamilton, F., King, N., Pavan, P.: Remote usability evaluations with disabled people. In: Proceedings of ACM CHI 2006, pp. 1133–1141 (2006) 27. Ramey, J., Boren, T., Cuddihy, E., Dumas, J., Guan, Z., van den Haak, M.J., Jong, M.D.T.D.: Does think aloud work? How do we know? In: CHI 2006 extended abstracts on Human Factors in Computing Systems, pp. 45–48. ACM, New York (2006)

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28. Rosson, M.B., Carroll, J.M.: Usability engineering: Scenario-based development of human-computer interaction. Morgan Kaufmann, San Francisco (2002) 29. Tavris, C., Aronson, E.: Mistakes were made. Harcourt (2000) 30. Thimbleby, H.: Press On: Principles of interaction programming. MIT Press, Boston (2007) 31. Thimbleby, H.: User-centered methods are insufficient for safety critical systems. In: Holzinger, A. (ed.) USAB 2007. LNCS, vol. 4799, pp. 1–20. Springer, Heidelberg (2007) 32. Thimbleby, H., Addison, M.A.: Intelligent adaptive assistance and its automatic generation. Interacting with Computers 8(1), 51–68 (1996) 33. Thimbleby, H., Thimbleby, W.: Internalist and externalist HCI. In: BCS HCI 2007, vol. 2, pp. 111–114 (2007) 34. Wharton, C., Rieman, J., Lewis, C., Polson, P.: The cognitive walkthrough method: A practictioner’s guide. In: Nielsen, J., Mack, R.L. (eds.) Usability Inspection Methods (1994) 35. Widdup, E.: We told T5 bosses the system was a farce. . . they ignored us. London Evening Standard 9, 17 (2008) 36. Wixon, D.R.: Evaluating usability methods: Why the current literature fails the practitioner. Interactions 10(4), 28–34 (2003)

Introduction to the Special Thematic Session: Human–Computer Interaction and Usability for Elderly (HCI4AGING) Andreas Holzinger1, Kizito Ssamula Mukasa2, and Alexander K. Nischelwitzer3 1

Medical University Graz, A-8036 Graz, Austria Institute for Medical Informatics, Statistics & Documentation (IMI) Research Unit HCI4MED [email protected] 2 Fraunhofer Institute for Experimental Software Engineering (IESE) Department of Requirements and Usability Engineering [email protected] 3 University of Applied Sciences Graz, School of Information Management Digital Technology Laboratory [email protected] Abstract. Industrialized countries are faced with severe demographical and social changes. Consequently, areas including Ambient Assisted Living are of increasing importance. The vision is to provide technologies for supporting (elderly) people in their daily lives, allowing them to stay longer within their own home aiming at living independent and self-determined. User Interfaces in such systems are mostly multimodal, because standard interfaces have limited accessibility. Multimodal user interfaces combine various input and output modalities (including seeing/vision, hearing/audition, haptic/tactile, taste/gustation, smell/olfaction etc) which are classical research areas in Human-Computer Interaction (HCI) and Usability Engineering (UE). One of the advantages of multiple modalities is increased usability: the weaknesses of one modality are offset by the strengths of another. For example, on a mobile device with a small visual interface and keypad, a word may be quite difficult to read/type, however very easy to say/listen. Such interfaces, in combination with mobile technologies, can have tremendous implications for accessibility and can be a benefit for people. An important issue is that interfaces must be accessible, useful and usable. Traditionally, HCI bridges Psychology/Pedagogy and Informatics, while UE is anchored in software technology. Together, HCI&UE provide the emerging potential to assist the daily workflows in the realm of AAL. This special thematic session is devoted to promote a closer collaboration between Psychologists, Pedagogues and Computer Scientists. Keywords: Human–Computer Interaction, Usability Engineering, User Interfaces, Older Adults.

1 Introduction and Motivation for This Special Thematic Session In most industrialized countries the demographical, structural and social trends tend towards more and more elderly people in single households, which definitely has K. Miesenberger et al. (Eds.): ICCHP 2008, LNCS 5105, pp. 18–21, 2008. © Springer-Verlag Berlin Heidelberg 2008

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effects on health care, emergency medical services and of course of the individuals themselves [1]. Older people and new technologies are one of the important research and development areas [2], where accessibility, usability and life long learning play a major role. For example, intelligent User Interfaces (IUI) for Ambient Assisted Living (AAL) intend to support elderly by application of intuitive and natural interaction [3]. However, such applications must be designed and developed to support the needs, the new, and special, demands and requirements of the individual end users. Clear benefits must be offered, whether in a physical, medical, emotional, motivational or educational respect. The design and development of IT must support the elderly end users, especially to overcome their fears and enable them to accept technological aids and mobile devices without reservations. The design must then reflect the acceptance of the end users and not be the cause of new biases [4]. In order to ensure this, the HCI community developed a variety of User–Centered Design (UCD) techniques during the last 15 years [5], which are meanwhile established usability engineering methods [6]. Unfortunately, UCD concentrates mainly on externalist human issues [7], with the risk of ignoring important internalist issues, although the technological issues are equally important [8]. The HCI community has hoped to fix all problems by even better user-centered methods, but UCD alone is insufficient [9]. The appropriate methods behind are very different and come from various backgrounds with often completely different styles of working [10]. Consequently, in this special thematic session we aim to bring together people from Psychology, Pedagogy and Computer Science. And we are of the opinion that they are equally important and exactly those fields can contribute to the overall goal of computing helping people with special needs.

2 The Special Thematic Session Program From a total of 24 papers submitted to this special thematic session, 11 were carefully selected after peer review: After a brief introduction to the special thematic session, presenter 1, Holzinger et al., from Austria, starts with an investigation on the acceptance of ubiquitous devices within the real-life environment of a special clinic for elderly people suffering from dementia. Followed by presenter number 2, Julio Abascal et al., from Spain, with a report on the design of adaptive interfaces for supportive ambient Intelligence environments for the elderly. Presenter 3, Eduardo Carrasco et al., from Spain, demonstrates advances in interaction between virtual characters and persons with Alzheimer’s disease. Followed by Sergio Sayago et al., also from Spain, exploring the role of time and errors in real-life usability for older people. Jarek Krajewski et al., from Germany, presents an acoustic framework for detecting fatigue in speech based Human-Computer-Interaction. Presenter 6, Martina Ziefle et al., from Germany too, demonstrates visual and auditory interfaces of advanced driver assistant systems for older drivers. Followed by Emiliano Castellina et al., from Italy, who talks about eye tracking impact on quality-of-life of ALS patients. Presenter 8, Ulrike Bechtold et al., from Austria, talks about participative approaches for technology and autonomous living of the elderly. Rüdiger Heimgärtner, et al., from Germany, presents some issues from

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cultural to individual adaptive user interfaces to help people with special needs. Followed by Martina Ziefle et al., with a paper on the effects of icon concreteness and complexity on semantic transparency: younger versus older users. And the 12th and final presentation is provided from Andreas Holzinger et al. on investigating usability metrics for the design and development of applications for the elderly. Of course this can only be a small step towards reaching the goals of making technology easier accessible for our elderly generation, however, every great leap must start with a small step.

Acknowledgements We are grateful to the Special Thematic Session Board who supported this Special Thematic Session enthusiastically: Ray ADAMS, Middlesex University London and Cambridge University, UK; Henning Boje ANDERSEN, Risoe National Laboratory, Danish Technical University, Roskilde, DK; Sebastian ADAM, Fraunhofer Institute for Experimental Software Engineering IESE, DE; Sheikh Iqbal AHAMED, Marquette University, US; Martin BECKER, Fraunhofer Institute for Experimental Software Engineering IESE, DE; Timothy W. BICKMORE, Northeastern University, US; Datong CHEN, Carnegie Mellon University, US; Matjaz DEBEVC, University of Maribor, SI; Anna DICKINSON, University of Dundee, UK; Alois FERSCHA, Linz University, AT; Vlado GLAVINIC, University of Zagreb, HR; Peter GREGOR, University of Dundee, UK; Bin HU, City University, Birmingham, UK; Simeon KEATES, Cambridge University, UK; Sri KURNIAWAN, University of Manchester, UK; ZongKai LIN, Chinese Academy of Science, Peking, CN; Gerd MIETZEL, University Duisburg-Essen, DE; Alan F. NEWELL, University of Dundee, UK; Colette NICOLLE, Loughborough University, UK; Philippe PALANQUE, University Toulouse, FR; Helen PETRIE, University York, UK; Fabio PITTARELLO, Ca' Foscari University Venice, IT; Margit POHL, Vienna University of Technology, AT; Anthony SAVIDIS, ICS FORTH, Heraklion, GR; Albrecht SCHMIDT, University Essen-Duisburg, DE; Ahmed SEFFAH, Concordia University, Montreal, CA; Yuanchun SHI, Tsinghua University, Peking, CN; Silke STEINBACH-NORD-MANN, Fraunhofer, Institute for Experimental Software Engineering IESE, DE; Hironobu TAKAGI, IBM Tokyo Research Laboratory, JP; Harold THIMBLEBY, Swansea Univeristy, UK; Gerhard WEBER, University Dresden, DE; Panayiotis ZAPHIRIS, City University London, UK; Martina ZIEFLE, RWTH Aachen, DE.

References 1. Kleinberger, T., Becker, M., Ras, E., Holzinger, A., Müller, P.: Ambient Intelligence in Assisted Living: Enable Elderly People to Handle Future Interfaces. In: Stephanidis, C. (ed.) UAHCI 2007 (Part II). LNCS, vol. 4555, pp. 103–112. Springer, Heidelberg (2007) 2. Emiliani, P.L., Stephanidis, C.: Universal access to ambient intelligence environ-ments: Opportunities and challenges for people with disabilities. IBM Systems Journal 44(3), 605–619 (2005) 3. Mukasa, K.S., Holzinger, A., Karshmer, A.I.: Intelligent User Interfaces for Ambi-ent Assisted Living, Fraunhofer IRB 121 (2008)

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4. Holzinger, A., Searle, G., Nischelwitzer, A.: On some Aspects of Improving Mobile Applications for the Elderly. In: Stephanidis, C. (ed.) Coping with Diversity in Universal Access, Research and Development Methods in Universal Access. LNCS, vol. 4554, pp. 923–932. Springer, Heidelberg (2007) 5. Norman, D.A., Draper, S.: User Centered System Design. Erlbaum, Hillsdale (1986) 6. Holzinger, A.: Usability Engineering for Software Developers. Communications of the ACM 48(1), 71–74 (2005) 7. Thimbleby, H., Thimbleby, W.: Internalist and Externalist HCI HCI 2007. British Computer Society (2007) 8. Thimbleby, H.: Press on: Principles onf Interaction Programming. MIT Press, Cam-bridge (2007) 9. Thimbleby, H.: User-Centered Methods Are Insufficient for Safety Critical Systems. In: Holzinger, A. (ed.) USAB 2007. LNCS, vol. 4799, pp. 1–20. Springer, Heidelberg (2007) 10. Carroll, J.M.: Human-computer interaction: psychology as a science of design. International Journal of Human-Computer Studies 46(4), 501–522 (1997)

An Investigation on Acceptance of Ubiquitous Devices for the Elderly in a Geriatric Hospital Environment: Using the Example of Person Tracking Andreas Holzinger1, Klaus Schaupp2, and Walter Eder-Halbedl3 1

Medical University Graz, A-8036 Graz, Austria Institute for Medical Informatics, Statistics & Documentation (IMI) Research Unit HCI4MED [email protected] 2 Graz General Hospital LKH-West A-8020 Graz, Austria [email protected] 3 General Hospital LKH Fuerstenfeld A-8280 Fuerstenfeld, Austria [email protected]

Abstract. In this study, we investigate the acceptance of radio frequency identification (RFID) technology for localizing elderly people, suffering from dementia. We discuss how, and to what extend, we can balance economic and humanistic interests versus patient privacy and other libertarian concerns. We used specifically developed questionnaires and guided interviews and investigated the opinions, attitudes and beliefs of both medical professionals and patients. For this purpose, one of the most modern equipped geriatric clinics has been examined: the Albert Schweitzer clinic of the Geriatric Center Graz. The findings showed that RFID technology provides enormous economic benefits for both medical professionals and patients, whilst at the same time; these invasive surveillance technologies threaten our patients’ privacy. Most astonishing was that almost all of the people involved, were unaware of both opportunities and problems of such ubiquitous devices. Similar to many new and emerging technologies, it has the potential to both benefit and harm society. Keywords: Human–Computer Interaction, Usability, Acceptance, Ubiquitous Computing, Hospital, Older Adults, Person localization.

1 Introduction and Motivation for Research One of the utmost concerns in health care is the growing proportion of people of advanced age [1]. Demographical, structural and social trends tend towards more and more elderly people, which may have dramatic effects on health care [2]. The increasing amount of information technology being designed and developed for both the care givers and these potential patients must support their needs, demands and requirements. A clear benefit must be offered, whether in a physical, medical or emotional respect. The benefit of using new devices must be appreciable, in order to K. Miesenberger et al. (Eds.): ICCHP 2008, LNCS 5105, pp. 22–29, 2008. © Springer-Verlag Berlin Heidelberg 2008

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provide a motivation for its use, and the balance between intuitive use and awareness of its potential problems [3]. In previous studies within hospital settings [4], [5] the lack of combination of technological and socio-psychological issues have been described. However, it is exactly this combination of psychological and technological research, which will assist ubiquitous computing (UC) to reduce problems and to generate new improvement potential in Health Care. Empirical evidence on tracking people with RFID-based tags is particularly rare [6]; consequently research in this area is urgently required.

2 Theoretical Background and Related Work Many new technologies have been developed to promote safe mobility of geriatric patients and to eliminate or alleviate adverse events, for example patient falls, bedrail entrapment, and most of all patient wandering [7]. Many institutions pursue projects that focus on smart living spaces, for example the MIT AgeLab and PlaceLab [8]. Large companies, including Microsoft, Intel, Philips Honeywell, have made commitments to research and develop technologies for independent living and proactive health care [9]. Previous work describes existing infrastructure and improvements with UC in hospitals [10]. Many elderly people are suffering more or less from dementia, which can be described as a progressive decline in cognitive functions. Affected areas in cognition include, amongst others: memory, attention, orientation and location, the latter resulting in uncontrolled wandering; and there is no evidence so far to recommend the use of any non-pharmacological intervention to reduce or prevent wandering in people with dementia [11]. People suffering from dementia have no ability to perform even simple daily activities (Activities of daily living - ADL) due to the lack of remembering the proper sequence of events and on how to use the required tools, and most of all, they can bring themselves into dangerous situations [12]. Consequently, technology to assist people with dementia is highly necessary and much is available today. Lawson (2001) was one of the few, who took not only technology for people with dementia into consideration, but developed dimensions of quality of life, taking into account aspects of autonomy, privacy, dignity, spiritual well-being, functional competence, comfort, security, individuality and enjoyment [13]. However, most of the developed technology has been tested in the infrastructure of laboratories rather than been researched in real-life within hospitals. Contributing towards stimulating further research in the field, was our main motivator for this work.

3 Materials and Methods 3.1 Experimental Environment: The Albert Schweitzer Clinic II The Albert Schweitzer hospital II was established on the premises of the Geriatric Health Center Graz (Geriatrischen Gesundheitszentren, GGZ). This establishment encompasses a "Memory Clinic" with 22 beds and an attendant "garden of the senses", as well as 120 beds for Geriatric Medicine. Within the hospital, there is a day

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clinic, an acute-geriatric and remobilization clinic, a coma vigil station - Appalic Care Unit, and the Albert Schweitzer Hospice. Geriatric medicine involves treating patients whose clinical picture shows the necessity of constant medical, custodial, psychological treatment and nursing. A significant goal is the promotion of physical and mental efficiency. The Memory Clinic is particularly important: The goal of the multiprofessional team is to ensure the highest possible quality of life and personal liberty, while continuing to ensure security and the promotion of existing abilities. The patients being treated are mobile, with light to moderate dementia; who exhibit conspicuous behavioural traits and have special care requirements. One manifestation of dementia is constantly increasing cognitive restriction. The progress of the illness, and the associated memory loss, causes incorrect assessment of danger in daily activities. The need to arrange their life independently and autonomously remains, making it necessary to provide technical precautions to minimize their risk. The GGZ installed technical facilities and equipment in order to create appropriate freedom for their patients. 3.2 Technical Solution: Person Tracking The company Kapsch provided the GGZ with a communication solution based on IP technology. A principal component of the system is the localization of disoriented patients with the assistance of a WLAN infrastructure. The complete area of the Albert Schweitzer Clinic premises, including the external areas, was equipped with a Cisco WLAN solution. There are currently 170 Cisco Access points (AP's) of the type 1131 on 5 central WLAN Controllers. The wireless LAN control system (WCS) of the CISCO Company is implemented as the management solution, in case of failure of an AP the surrounding APs can supply this sector. All Access Points are supplied with electricity centrally by the floor distributors (Power over Ethernet). A cluster of two Cisco call managers for approx. 500 IP Phones was already accessible in the network of the city of Graz. An intensive test of both Cisco and Siemens WLAN IP Telephony was made in the GGZ. The Cisco solution was chosen due to the substantially better quality of the terminals and the redundancy concept. In addition to the two existing servers in Graz, a third was installed in the GGZ computing centre, and an upgrade was made to Cisco Unified Communication manager 5.1. If one of the three servers fails, either of the other two takes over this service without interrupting communication. Today, approx. 120 WLAN IP phones of the type Cisco 7921 are employed, WLAN IP Phones from Ascom and GSM and WLAN dual mode phones from Nokia are currently being used experimentally. The system offers the possibility of telephony (wired and wireless) connection via SIP. Thus, diverse terminals (different manufacturers) and systems can be simply integrated. The existing telephone system will continue to be used for cabled (wired) telephones. A particular advantage of this solution is the simple administration of the system via graphic interfaces. Individual domains are defined with different administrators (GGZ, Businesses, City of Graz), so that each administrator can only configure "its" own IP Phones. In December 2007, in the course of a large redundancy test in the City of Graz Net, all possible failure scenarios in a controlled, real-time operation, were run through, however, the system proved to be successful.

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3.3 Localization of Disoriented Persons After the implementation of the WLAN infrastructure described above and the WLAN telephone solution, the "Deso" solution from Kapsch was also implemented. The components employed were: Cisco Location Appliance, Kapsch Alarmserver, Kapsch AeroScout Dienst & User Interface, AeroScout Exiter, AeroScout TAGs. The Cisco location Appliance is a component, which, as an addition to the Wireless Control System (WCS) makes omni-directional and full-coverage localization possible; i.e., with appropriate positioning of the Access Points, a "rough" localization of a WLAN terminal with an estimated accuracy of 5 – 10 meters is possible. However, for the application area of the GGZ this is not sufficient. In principle, the disoriented patients are “assigned” areas in which they can move about freely. AeroScout Exiters are affixed to the exits. Consequently, one can rely on an alarm when a patient leaves the area. Additionally, the clear areas are supervised, in order to carry out a rough positioning (see above). The patients concerned receive an AeroScout Tag (see figure 1). This is a WLAN component, which was specially developed for the localization of people or special medical devices (e.g. infusion pumps etc.). The tag is attached to the patient either as bracelet, collar or sewn into their clothes.

Fig. 1. (right): AeroScout attached to a patient

Fig. 2. (left): A 15 minutes interval localization screen

The tags communicate with the WLAN infrastructure in programmable, intermittent, intervals. The maintenance personnel assign a tag to the patient and enter the sector, within which the patient may move. Should the patient leave this sector, the tag sends a signal to the alarm server, which in turn calls the maintenance personnel and notifies them. The approximate position of the patient in the area of the GGZ can

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Fig. 3. (right): The position of the Exiter within the building

Fig. 4. (left): The Exiter Access Point

then be determined over the WCS. All the services provided by the company Kapsch run on a Linux Server and are managed using graphic interfaces (PHP), with the exception of the Kapsch Alarm Server (K-AS), which is the heart of the system, was installed in January 2008 and runs under Windows. The main advantages of our K-AS are the large flexibility of the alarm input and output possibilities, its modular architecture and the speech alarm. K-AS is used in the general health sector, also in the university clinic Graz (among other things for red alerts) and in the Rehab Tobelbad. The City of Graz already had a K-AS for an alert in the case of network and IT problems. Therefore, this could be configured to provide a mutual monitoring of the alarm servers in the GGZ and the City of Graz. A system running on Windows has a very high expenditure for patching and therefore the threat from viruses and similar problems is substantially larger than with a Linux system, for this reason the distributed alarm servers will only run on Linux systems. Oracle is used for the central data base (and for the alarm server) in the GGZ. The standard data base is MySQL. 3.4 Evaluation The Structured Interview Model was selected for the empirical investigation since the range of topics was clearly outlined [14], [15]. Since different approaches to this theme were available to the interviewers (technical training versus commercial training), specifically the Tandem Interview Model was applied [16]. The question catalogue was arranged as follows: introduction and background of the questionnaire; objective of the survey; duration of the interview; questionnaire; The actual questionnaire covered three prime data areas; institution; patients; relations; On the basis of this questionnaire, N=25 people from the fields of management, hospital services, physicians, nursing staff and social work were interviewed in their familiar environment [17].

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4 Results and Discussion "Ethics is the boundless extension of responsibility towards everything that lives" This quotation from Dr. Albert Schweitzer is placed in the forefront of the GGZ’s mission statement. All actions, and everything done by the people interviewed, are in the mission statement of the GGZ: “Meet Life with a Smile”. The patients are cared for according to the "Psychobiography Health Care Model" of Erwin Boehm. In the foreground, there is always: what is necessary for the patient. Therefore, quality of life, security and protection rank in the highest places. The results of the interviews showed clearly: The people being cared for must come first, and only as much technology as can be absolutely medically, moral and ethically justified, may be used. These results agree with the mission statement. It is interesting that, while the employees concerned considered the tracking of persons suffering from dementia a necessity, they reacted negatively to the idea of surveillance. According to § 3(1) of the Heimaufenthaltsgesetztes (Home Residence Act) of 2004, monitoring is considered as an infringement of liberty. This is demonstrated "when a patient or person being cared for is physically prevented, against their will or without their permission, from changing their location, in particular by mechanical, electronic or medicinal measures, or by the threat thereof". In § 5 of the Heimaufenthaltsgesetztes (Home Residence Act), who may arrange surveillance, which formal criteria are to be fulfilled and when the infringement of liberty is to be removed, is regulated. It is also regulated, how the measures are to be documented (§ 6) and how the information and communication is to take place (§ 7). Surveillance by means of AeroScout is therefore, in the legal sense, an infringement of liberty and must therefore be regarded as extremely sensitive. The evaluation of the individual questionnaires showed that there is a consensus regarding the employment of the technology. It is interesting that almost all interview partners possessed no knowledge of the possibilities of RFID technology. At the same time, they are satisfied with the DesoSystem currently in use. The people concerned with the care and nursing of the patients, were equally unambitious when it came to suggesting ideas as to the use of further supporting technology. When it concerned the decision, as to whether the AeroScout is to be used, in other words to monitor the patient’s movements, it was clear to everyone involved that an appropriate diagnosis and the observation of the nursing staff care are crucial for a team resolution.

5 Conclusion and Future Outlook The rapid advances being made daily mean that we are unable to anticipate exactly what aids will be available and how these will affect lives. In order to prepare the elder population to live longer and more independent lives with the help of this technology, we must first introduce them, not to any particular device but to the concept of modern engineering. They must be willing to judge innovations on their merits rather than rejecting them out of hand. This awareness and acceptance can be fostered and increased by education and example. The industry must be cognizant of the fact that awareness training must go hand-in-hand with good design and that knowledge of

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the user is as important as functionality, since without the user’s cooperation, functionality must be ineffective. Much further work is needed to enhance quality of the development for the Elderly, especially for those suffering from dementia.

Acknowledgements We are grateful to all participants and supporters of the GGZ and for technical support of: TAGnology (Mr. Markus Schriebl), NXP (Mr. Peter Schmallegger) and Kapsch BusinessCom AG (Mr. Thomas Hausegger).

References 1. Mezey, M., Capezuti, E., Fulmer, T.: Care of older adults - Preface. Nursing Clinics of North America 39(3), XIII–XX (2004) 2. Kleinberger, T., Becker, M., Ras, E., Holzinger, A., Müller, P.: Ambient Intelligence in Assisted Living: Enable Elderly People to Handle Future Interfaces. In: Stephanidis, C. (ed.) UAHCI 2007 (Part II). LNCS, vol. 4555, pp. 103–112. Springer, Heidelberg (2007) 3. Holzinger, A., Searle, G., Nischelwitzer, A.: On some Aspects of Improving Mobile Applications for the Elderly. In: Stephanidis, C. (ed.) HCI 2007. LNCS, vol. 4554, pp. 923– 932. Springer, Heidelberg (2007) 4. Holzinger, A., Schwaberger, K., Weitlaner, M.: Ubiquitous Computing for Hospital Applications: RFID-Applications to enable research in Real-Life environments. In: 29th International Computer Software & Applications Conference (IEEE COMPSAC), pp. 19–20 (2005) 5. Weippl, E., Holzinger, A., Tjoa, A.M.: Security aspects of ubiquitous computing in health care. Springer Elektrotechnik & Informationstechnik, e&i 123(4), 156–162 (2006) 6. Xiao, Y., Yu, S.H., Wu, K., Ni, Q., Janecek, C., Nordstad, J.: Radio frequency identification: technologies, applications, and research issues. Wireless Communications & Mobile Computing 7(4), 457–472 (2007) 7. Nelson, A., Powell-Cope, G., Gavin-Dreschnack, D., Quigley, P., Bulat, T., Baptiste, A.S., Applegarth, S., Friedman, Y.: Technology to promote safe mobility in the elderly. Nursing Clinics of North America 39(3), 649–671 (2004) 8. MIT: AgeLab (last access: 2008-02-12), http://web.mit.edu/agelab 9. Walker, S.A., Sarfatti, M.: Technology and aging: the untapped potential. Interactions 14(4), 22–23 (2007) 10. Bardram, J.E.: Applications of context-aware computing in hospital work: examples and design principles 2004 ACM symposium on Applied computing, pp. 1574–1579 (2004) 11. Robinson, L., Hutchings, D., Corner, L., Beyer, F., Dickinson, H., Vanoli, A., Finch, T., Hughes, J., Ballard, C., May, C., Bond, J.: A systematic literature review of the effectiveness of non-pharmacological interventions to prevent wandering in dementia and evaluation of the ethical implications and acceptability of their use. Health Technology Assessment 10(26), 1–124 (2006) 12. Mihailidis, A., Barbenel, J.C., Fernie, G.: The efficacy of an intelligent cognitive orthosis to facilitate handwashing by persons with moderate to severe dementia. Neuropsychological Rehabilitation 14(1-2), 135–171 (2004) 13. Lawton, M.P.: The physical environment of the person with Alzheimer’s disease. Aging & Mental Health 5(2), 56–64 (2001)

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14. Preece, J., Rogers, Y., Sharp, H., Benyon, D., Holland, S., Carey, T.: Users’ Opinion: Interviews and questionnaires. Human-Computer Interaction, Pearson Education, 628–639 (1994) 15. Newman, L.: Interview Method. In: Stanton, N., Hedge, A., Brookhuis, K., Salas, E., Hendrik, H. (eds.) Handbook of Human Factors and Ergonomics Methods, pp. 77–1–77–5. CRC Press, Boca Raton (2005) 16. Bortz, J., Döring, N.: Forschungmethoden und Evaluation für Sozialwissenschaftler. Springer, Heidelberg (1995) 17. Lamnek, S.: Qualitative Sozialforschung, Band 2: Methoden und Techniken. Beltz, Weinheim (1995)

Adaptive Interfaces for Supportive Ambient Intelligence Environments Julio Abascal, Isabel Fernández de Castro, Alberto Lafuente, and Jesus Maria Cia Laboratory of Human-Computer Interaction for Special Needs Informatika Falultatea University of the Basque Country-Euskal Herriko Unibertsitatea Manuel Lardizabal 1, 20018. Donostia. Spain {julio.abascal,isabel.fernandez,alberto.lafuente}@ehu.es [email protected]

Abstract. The Ambient Intelligence paradigm offers an excellent way to define Ambient Assisted Living systems for all kind of users. In addition, people with physical, sensory or cognitive restrictions are expected to particularly benefit from the support of intelligent environments. Nevertheless, the huge diversity of users’ characteristics makes very difficult to develop interfaces that are adequate for all of them in order to successfully interact with the environment. Even if a “Design for All” approach is assumed and adaptive interfaces are adopted, it is almost impossible to fulfill the diverse, and frequently contradictory, requirements of the different users. This paper presents an experience of designing adaptive interfaces oriented to the needs of the elderly people living in an intelligent environment. These interfaces are integrated in an architecture destined to build complex Ambient Intelligent environments that share resources –mainly hardware and heterogeneous networks– and knowledge. Keywords: Adaptive Human-Environment Interfaces for Elderly People, Ambient Intelligence, Ambient Assisted Living.

1 Introduction The fast development experienced by Ambient Intelligence in the last years permitted the development of the Ambient Assisted Living concept, focused on environments that proactively support the users. However, despite of the numerous attractive scenarios that have been devised and carefully described, the design of the interface between the user and the system is still unclear. Most authors agree on the need of directing the work through the so called “natural interfaces”. In most cases it means that the user will spoke to the system. Therefore the system has to be able to understand spoken natural language and probably to perform some gesture recognition. The environment should communicate with the user mainly by means of voice messages, even if some complex information may require written messages displayed in large mural screens or in small displays built in wearable devices (watches, glasses, mobile telephones, etc.). Nevertheless, something which is “natural” for many users may be “banned” for others. For instance, some K. Miesenberger et al. (Eds.): ICCHP 2008, LNCS 5105, pp. 30–37, 2008. © Springer-Verlag Berlin Heidelberg 2008

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people with sensory, motor or cognitive restrictions can experience difficulties to utter sentences that the system can understand. In addition, they may have diverse degree of difficulties to hear, read or understand the messages coming from the environment. Therefore, they require different ways to interact with the system. Among people that can experience restrictions, elderly people compose a human collective with an enormous diversity. With the pass of the time, people tend to experience physical, sensory or cognitive restrictions and, in some cases, they may be included in the collective of people with disabilities. Nevertheless, a disability oriented approach is not adequate for elderly people. Therefore, the design of the usersystem interface for elderly people living in Ambient Assisted Environments require a specific approach that takes into account their special physical and cognitive features. This paper presents an architecture to built adaptive interfaces to support elderly people living in intelligent environments. As a part of this architecture, intelligent agents interact with the users and share knowledge with other intelligent applications by means of a novel Intelligent Services Interface level. The proposal has been tested in the PIAPNE project that is briefly described.

2 Requirements of the Interfaces for Elderly People As an extension of the requirements described in [1], in order to appropriately interact with elderly people an interface requires the following features: Efficient, Supportive, Rehabilitative, Adaptive, Non-disruptive and Ethically Aware. • Efficient: It must be able to both collect the request from users and to communicate the necessary information in an effective way. • Supportive: Users must be empowered by the interface. The system must sustain their ability to develop by themselves any kind of tasks they desire and can do. In addition the system must help them managing the tasks they cannot do or are not interested in. • Rehabilitative: When possible, the system must stimulate users to recover functions and abilities that are restricted and must maintain the ones that are active. • Adaptive: The communication must be adapted to the modalities the user can handle and understand (taking into account that they may have physical, sensory or cognitive restrictions impeding the use of some standard input/output devices or modalities [2]). • Non-disruptive: Explicit communication with the user must be initiated by the system only when it is strictly necessary and avoiding disturbing the execution of other tasks, unless urgent safety-related actuations are required. • Ethically aware: The system cannot take decisions on behalf of the user without his or her consent. The transmission and storing of sensitive information about the user (such as health habits, behavior patterns, etc.) must be encrypted while it is being used and erased when it is no longer necessary. In addition, “informed consent” is required for people who are being monitored or tracked [3].

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Some of these requirements are not technological. Nevertheless they can not be ignored in the design. Systems developed without taking into account psychological, social or ethical “side effects” may produce considerable impact in the autonomy, privacy or the users’ way of life. Frequently these effects are deeply routed in the conceptual design of the system and may not be removed without a complete redesign.

3 Adaptive User Interfaces for Elderly People Adaptive interfaces are able to modify their appearance and behavior in order to adjust themselves to the user’s current needs and interests. The knowledge of the current value of a number of selected parameters that characterize the user and the interaction context can be used to optimize the communication. These parameters are usually grouped in models and stereotypes that allow reasoning about the desirable functionality of the interface for each different situation. Therefore, adaptive interfaces must include mechanisms to make assumptions about the current status of several observable and relevant parameters. For elderly people living in an intelligent environment, we have designed three models: User Model, Task Model and Environment Model. The objective is to determine how the system has to react when a specific user is in a particular place doing a specific task. The User Model records physical, sensory and cognitive characteristics of the user, such as Hearing (normal, hard of hearing, deaf), Vision (normal, low vision, blind), Reaction Capacity (slow, medium, fast), Movement Precision (low, high), Speech (normal, dysarthric), Orientation Capacity (low, high), etc. In addition, user profiles and stereotypes can be defined for the possible meaningful combinations of these parameter values. Changes in some of these parameters are extremely slow (e.g. hearing or vision capacity), while other parameters can suffer sudden modifications (e.g. reaction time and movement precision may decay very quickly due to fatigue, whilst they may enhance due to interest or motivation). There are parameters that vary smoothly with the learning process (e.g. orientation capacity). Therefore, an adaptive interface continuously estimates these parameters and compares them with the user profiles. In this way it can make assumptions about the current state of the user and decide the modality and the type of devices needed to communicate with him or her. The Task Model records the set of well identified and described tasks that can be performed (e.g. eating, slipping, using the toilet, etc.) and the restrictions (of time, place, etc.) for each one. In order to be able to recognize whether a user is performing a specific task they are characterized by patterns of values collected by sensors. When the system has detected which task is currently performed by the user it can verify the presence of potential safety risks. In addition, the interface can make assumptions that allow disambiguating the user requests and commands. Task modeling also allows easing the communication with the user for everyday support: when the user is performing a particular task, only the possible actions related to that task are offered to the user. The Context Model is built as a topological map, similar to the ones used by mobile robots. With the data received from the location system, this model determines

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where in the map is exactly the user. Taking into account the restrictions for users, places and times, the intelligent application can verify whether a task is being performed in an appropriate place, or whether unexpected activities are happening in a particular position. From the point of view of the interface, the location of the user allows to select the particular input/output devices that must be used for communication. In addition it helps in the disambiguation of location-dependent user requests such as “Switch on the lights”. 3.1 User Interface for Elderly People Support For our purpose we consider semi-autonomous elderly people living in a flat provided with enough infrastructures such as diverse types of networks, sensors and processors. The interface must be clear and supportive. It should help elderly people to develop everyday tasks, reminding them times, places and procedures. In addition it should be able to easily understand and perform user’s commands. The mode of the interaction depends on the user sensory and cognitive characteristics. The adaptive interface provides coherent multimedia messages that can be easily understood by the users. In the current implementation voice messages and text messages (appearing in a TV screen) are being used and tested. The user requires services or provides commands by means of voice orders or using a remote control for TV. Users wear a discrete tag to be located and to monitor body position, in order to detect falls, strokes, etc. In addition a network of heterogeneous sensors, provide environment information such as temperature, humidity, status of the lights, gas, water, etc. This scenario can be extended to another one where elderly people with dementia live in a residential institution. In this case, the user interface must be very simple, since the tasks they can perform autonomously are reduced. However, care personnel require advanced interfaces to monitor user’s safeness and health.

4 Sharing Information between the Environment and the Interface The technological support to Ambient Assisted Living –to help elderly people– may be provided by Ambient Intelligence systems through ubiquitous, distributed and wearable computing. Therefore, it is necessary to built technological infrastructure that allows the design of assistive environments able to supply coherent assistance to the users. Our approach to Ambient Assisted Living is based on the specification of different intercommunicating levels. This architecture allows the interconnection of diverse hardware elements through heterogeneous wired and wireless networks. A middleware level provides interoperability functions and solves presentation and networks compatibility [4]. In this architecture diverse adaptable user interfaces share the infrastructure and interact with the other levels through the Intelligent Services Interface, in order to handle user input/output devices, networks and applications, for communication and control.

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J. Abascal et al. Table 1. Use of the models by applications and interfaces

Intelligent Applications

Adaptive User Interfaces

- Characterization of the user: likes, capacities, - Modality for communication permissions, restrictions… - User interface device selection - Task requirements for safety verification: (Is - Reduction of the choices for the user allowed to perform this task?) message production Task - Requests’ disambiguation Model - Task performing assistance - User location (Where is the user?) - Reduction of the choices for - Spatial requirements for safety verification: message production Context (Is the task done in the appropriate place? Is - Requests’ spatial disambiguaModel the user allowed in this place [at this time]?) tion - Guidance of smart wheelchair - User guidance User Model

It cannot be forgotten that in this kind of environments multiple intelligent applications are running in parallel providing support to the user. Many of these applications need to handle models of the user, the task or the environment (see table 1). Nevertheless, to maintain separated models can suppose a waste of processing effort and a source of inconsistency. Therefore the choice for our approach is to share models among the diverse intelligent applications, including the adaptive interface. User Interface 1

User Interface 2

User

Intelligent application 1

… Interface n

Intelligent application 2

Intelligent

… application m

Intelligent Services Interface

Middleware Network 1 Hardware

Network 2 Hardware

Network 3

…

Hardware

Network k …

Hardware

Fig. 1. The proposed architecture

Taking into account the functions and behavior of adaptive interfaces in the proposed architecture each interface instance is conceived as an intelligent application. All the applications communicate and interchange or share information through the level, called Intelligent Services Interface (figure 1), that provides modeling information to the intelligent applications.

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In this way interfaces may be designed as proactive intelligent agents able to interact with other intelligent applications and to mediate between the user and the system. This approach very much simplifies the design of the interface, and allows the inclusion of new agents with new capabilities.

5 The PIAPNE Environment To test this approach the PIAPNE intelligent environment recreates a smart house where elderly people (maybe with physical, sensory or cognitive restrictions) receive intelligent environment support to maintain an independent way of life. The system is adaptive and context sensitive. In order to provide precise people location information the project used a room where an accurate Radio Frequency-based location system was deployed1. The location system collects the position of people wearing a discrete tag with 30 cm accuracy and sends these data to the application every 10 seconds. A snap-shot of the user location application can be found in figure 2.

Fig. 2. User location application

Diverse intelligent agents supervise users’ activities, to relate them to the place where they are being carried out and to detect risky situations. In this way, most dangers can be avoided and the user (or other responsible person) can be warned. In addition, the user can receive help to perform everyday tasks, either when the system detects a need for assistance or at the user’s request.

1

This location system was developed and tested by the Assistive Technology Research Group of the University of Zaragoza [5].

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By means of a stimulus/reaction mechanism agents are linked to the current status of the environment. In this way, their collective performance produces a sort of intelligent behavior. The domain requires the following features: immediate answer for real time performance, emergent activation to shoot alarms and modulation by allocation of specific tasks to each agent. The system has a mixed architecture combining both, an action-reaction rule architecture and a subsumption architecture that allows the activation or inhibition of agents by other agents of a higher level in the hierarchy. The intelligent agents are implemented in JESS. Each of them has a set of actionreaction type rules. The knowledge-base is composed of facts containing information collected from the environment by a network of sensors. In addition, it contains the current and previous tasks and users characteristics. PIAPNE environment is described with more detail in [1]. See below a fragment of a task recognizer written in JESS programming language. Fragment of the “cooking lunch” task recognizer written in JESS ;******************************************************** ; TASK: COOKING ;******************************************************** (defrule TASK-RECOGNIZER: cooking-lunch ?imp