User-Centred Design (UCD) and Participatory Action Research (PAR) have laid the foundations for Universal Accessibility. The inclusion of disabled end users in the design of digital Assistive Technology (dAT) is now an expectation within the accessibility field. However, some areas of dAT research fall short of this gold standard, especially when end users have speech, language and/or cognitive impairments. This is a particular challenge when developing technology for individuals who use Augmentative and Alternative Communication (AAC). In her ASSETS 2021 keynote talk, Prof. Waller provides a brief history of the development of AAC technologies since the early 1970s with a focus on users with severe speech and physical disabilities, illustrating that, despite significant advances in technology, the underlying design of AAC has not changed. This is in part due to challenges associated with the inclusion of a diverse user group in all stages of research from project ideation to product evaluation. She will demonstrate how a more inclusive approach might be achieved and will challenge the research community to consider the nature of interdisciplinary research teams and their role in setting the research agenda.

Current mechanisms for adopting and supporting high-tech augmentative and alternative communication (AAC) within special-education appear limited in their success, despite recognition of the potential benefits they represent for young emerging communicators. Prior research in this field has been restricted to discrete survey or interview methodologies. We present a five-month mixed-methods ethnographic study in a special-education school to explore the facilitators and barriers experienced by those using technology, with children who have little or no functional speech, to stimulate communication and language comprehension. Our analysis supports the outcomes of earlier studies, but also furnishes novel insights into the scale and urgency of addressing the problem—with implications for user-centred design within this community. We highlight infrastructure, policy, and recruitment deficits, and propose a two-fold solution: (i) an increase in engagement with this population through the provision of enhanced, user-centred support; and (ii) induction of the cross-disciplinary role of Assistive Technologist, to serve as mediator between teacher, aided communicator, and their assistive technology. This work represents a contribution towards establishing more effective operational, interactional, and pedagogical support for learners using high-tech communication devices.

Nonspeaking individuals with motor disabilities typically have very low communication rates. This paper proposes a design engineering approach for quantitatively exploring context-aware sentence retrieval as a promising complementary input interface, working in tandem with a word-prediction keyboard. We motivate the need for complementary design engineering methodology in the design of augmentative and alternative communication and explain how such methods can be used to gain additional design insights. We then study the theoretical performance envelopes of a context-aware sentence retrieval system, identifying potential keystroke savings as a function of the parameters of the subsystems, such as the accuracy of the underlying auto-complete word prediction algorithm and the accuracy of sensed context information under varying assumptions. We find that context-aware sentence retrieval has the potential to provide users with considerable improvements in keystroke savings under reasonable parameter assumptions of the underlying subsystems. This highlights how complementary design engineering methods can reveal additional insights into design for augmentative and alternative communication.

Despite its inherent challenges, participatory design (PD) has unique benefits when designing technology for children, especially children with special needs. Researchers have developed a multitude of PD approaches to accommodate specific populations. However, a lack of understanding of the appropriateness of existing approaches across contexts presents a challenge for PD researchers. This workshop will provide an opportunity for PD researchers to exchange and reflect on their experiences of designing with children with special needs. We aim to identify, synthesize and collate PD best practices across contexts and participant groups.

Globally, increasing numbers of people experience accessibility issues related to technology use. At the University ofDundee, we have developed a degree programme that aims to graduate socially-aware computing scientists who can develop for a range of access needs. To achieve this, we engage our students on a supported pathway of exploration, empathy and understanding. Students collaborate with user groups of older adults, adults with aphasia, and users of Alternative and Augmentative Communication (AAC). This practical experience leads to an understanding of the needs of the end-user and the need to develop for 'people who are not like me'

This article examines the educational efficacy of a learning environment in which children diagnosed with Autism Spectrum Conditions (ASC) engage in social interactions with an artificially intelligent (AI) virtual agent and where a human practitioner acts in support of the interactions. A multi-site intervention study in schools across the UK was conducted with 29 children with ASC and learning difficulties, aged 4--14 years old. For reasons related to data completeness and amount of exposure to the AI environment, data for 15 children was included in the analysis. The analysis revealed a significant increase in the proportion of social responses made by ASC children to human practitioners. The number of initiations made to human practitioners and to the virtual agent by the ASC children also increased numerically over the course of the sessions. However, due to large individual differences within the ASC group, this did not reach significance. Although no evidence of transfer to the real-world post-test was shown, anecdotal evidence of classroom transfer was reported. The work presented in this article offers an important contribution to the growing body of research in the context of AI technology design and use for autism intervention in real school contexts. Specifically, the work highlights key methodological challenges and opportunities in this area by leveraging interdisciplinary insights in a way that (i) bridges between educational interventions and intelligent technology design practices, (ii) considers the design of technology as well as the design of its use (context and procedures) on par with one another, and (iii) includes design contributions from different stakeholders, including children with and without ASC diagnosis, educational practitioners, and researchers.

Phoneme-based text entry provides an alternative typing method for nonspeaking individuals who often experience difficulties in orthographic spelling. In this paper, we investigate the application of rate enhancement strategies to improve the user performance of phoneme-based text entry systems. We have developed a phoneme-based predictive typing system, which employs statistical language modeling techniques to dynamically reduce the phoneme search space and offer accurate word predictions. Results of a case study with a nonspeaking participant demonstrated that our rate enhancement strategies led to improved text entry speed and error rates.

Communication within clinical settings is crucial for successful clinical practice. However, this is challenging when the clinician interacts with patients with Intellectual Disabilities (ID) who may have communication difficulties or find it difficult to understand the treatment process. The "Stories at the Dentist" project aims to develop a support tool to improve clinical communication between clinicians and patients with ID. This paper outlines a design workshop undertaken as part of a user centered design process.

Engaging with end users in the development of assistive technologies remains one of the major challenges for researchers and developers in the field of accessibility and HCI. Developing usable software systems for people with complex disabilities is problematic, software developers are wary of using user-centred design, one of the main methods by which usability can be improved, due to concerns about how best to work with adults with complex disabilities, in particular Severe Speech and Physical Impairments (SSPI) and how to involve them in research. This paper reports on how the adoption of an adapted agile approach involving the incorporation of a user advocate on the research team helped in meeting this challenge in one software project and offers suggestions for how this could be used by other development teams.

Technological supports have the potential to greatly improve the quality of life and independence of adults with severe speech and physical impairments (SSPI). In particular, augmentative and alternative communication (AAC) devices can enable people with little or no speech to communicate with others. However, the rate of rejection of AAC devices is estimated to be as high as 53.3%. It is suggested that a major reason for this rejection is a lack of user-centred design in the development of these devices. As part of a wider study looking at involving adults with SSPI in all stages of user-centred design, this paper looks at the use of focus groups in requirements gathering with this user group.

The high incidence of literacy deficits among people with severe speech impairments (SSI) has been well documented. Without literacy skills, people with SSI are unable to effectively use orthographic-based communication systems to generate novel linguistic items in spontaneous conversation. To address this problem, phoneme-based communication systems have been proposed which enable users to create spoken output from phoneme sequences. In this paper, we investigate whether prediction techniques can be employed to improve the usability of such systems. We have developed iSCAN, a phoneme-based predictive communication system, which offers phoneme prediction and phoneme-based word prediction. A pilot study with 16 able-bodied participants showed that our predictive methods led to a 108.4% increase in phoneme entry speed and a 79.0% reduction in phoneme error rate. The benefits of the predictive methods were also demonstrated in a case study with a cerebral palsied participant. Moreover, results of a comparative evaluation conducted with the same participant after 16 sessions using iSCAN indicated that our system outperformed an orthographic-based predictive communication device that the participant has used for over 4 years.

Children with complex communication needs who use voice output communication aids seldom engage in extended conversation. The “How was School today...?” system has been designed to enable such children to talk about their school day. The system uses data-to-text technology to generate narratives from sensor data. Observations, interviews and prototyping were used to ensure that stakeholders were involved in the design of the system. Evaluations with three children showed that the prototype system, which automatically generates utterances, has the potential to support disabled individuals to participate better in interactive conversation. Analysis of a conversational transcript and observations indicate that the children were able to access relevant conversation and had more control in the conversation in comparison to their usual interactions where control lay mainly with the speaking partner. Further research to develop an improved, more rugged system that supports users with different levels of language ability is now underway.

Currently available commercial Augmentative and Alternative Communication (AAC) technology makes little use of computing power to improve the access to words and phrases for personal narrative, an essential part of social interaction. In this paper, we describe the development and evaluation of a mobile phone application to enable data collection for a personal narrative system for children with severe speech and physical impairments (SSPI). Based on user feedback from the previous project "How was School today?" we developed a modular system where school staff can use a mobile phone to track interaction with people and objects and user location at school. The phone also allows taking digital photographs and recording voice message sets by both school staff and parents/carers at home. These sets can be played back by the child for immediate narrative sharing similar to established AAC device interaction using sequential voice recorders. The mobile phone sends all the gathered data to a remote server. The data can then be used for automatic narrative generation on the child's PC based communication aid. Early results from the ongoing evaluation of the application in a special school with two participants and school staff show that staff were able to track interactions, record voice messages and take photographs. Location tracking was less successful, but was supplemented by timetable information. The participating children were able to play back voice messages and show photographs on the mobile phone for interactive narrative sharing using both direct and switch activated playback options.

Proper seating and positioning is crucial in performing functional activities by individuals with neurological disabilities such as cerebral palsy. Subjective seating assessments are usually performed by physical and occupational therapists observing activities with different seating adaptations. Frequent assessments are required to maintain and adapt seating as individuals' physical characteristics change over time. We conducted a single case study with a 10 year old boy with cerebral palsy to investigate the potential use of accelerometers for the assessment of improved function due to postural support in seating. The results suggest that the root mean square values of acceleration correspond well with the subjective assessment of therapists that reduction in involuntary movements improves function.

In User-Centred Design (UCD) the needs and preferences of the end user are given primary consideration. In some cases, current methodologies such as interviewing may be difficult to conduct, for example when working with children, particularly those with Autism Spectrum Disorders (ASD). This paper outlines an approach to understanding the end-users, context and subject matter through the use of peer interviewing. This is proposed as a viable adaptation to User-Centred methodologies for inclusion of children and those with ASD.

A visit to hospital is traumatic for both a patient with disabilities and their family members, especially when the patient has no or limited functional speech [1]. For adults with Severe Speech and Physical Impairments (SSPI) being hospitalized presents particular challenges as hospital staff are often unaware of how the adult with SSPI communicates and what their basic care needs are.

The Straight-Talking User Group within Dundee University's School of Computing aims to create a place where adults with complex disabilities can meet to explore technology and where they can work with researchers to develop better technology. A pilot project has shown the potential for this type of centre is terms of increasing the self-esteem and motivation of participants and raising expectations of what people are able to achieve.

This paper presents a unique approach to undergraduate teaching in which accessibility topics are completely integrated throughout the curriculum, treating accessibility not as a separate topic, but rather as an integral part of design and development. Means of accomplishing this integration throughout the entire four-year curriculum are presented. We also describe how our expertise in accessible design has extended beyond the education of computer science and engineering students to include Web content authors across campus.

The need for intubated patients, within the intensive care setting, to communicate more effectively led to the development of ICU-Talk, an augmentative and alternative communication aid. The communication aid contains a database containing both core and patient-specific vocabulary. Many users of communication aids can provide direct input into the vocabulary, but intensive care patients are not in this position. This paper discusses the methods chosen to gather the vocabulary for an intensive care setting.

A Multi-disciplinary project staffed by personnel from nursing, computer science and speech and language therapy developed a computer based communication aid called ICU-Talk. This device has been designed specifically for intubated patients in hospital intensive care units. The ICU-Talk device was trialled with real patients. This paper reports the challenges faced when developing a device for this patient group and environment. A description of the methods used to produce ICU-Talk and results from the trials will be presented.

This paper reports on the use of predictive techniques to translate Blissymbol sentences into grammatically correct English. Evaluations of this approach show that it is possible to translate short sentences by analysing the likelihood of word tri-gram occurrences in English source texts. The translation system is designed to be a component of a Blissymbol word processor which allows users to convert Blissymbol sentences into grammatically correct English.

This paper details the development of ICU-Talk, a computer-based communication aid. This aid has been designed specifically for patients who are temporarily unable to communicate due to intubation and/or ventilation within a hospital intensive care unit (ICU). The very specific needs of this client group have been considered by the multi-disciplinary research team and incorporated into the design of the system.