We present DuoRhythmo, a collaborative accessible digital musical interface (CADMI) that gives people living with Amyotrophic Lateral Sclerosis (PALS) the experience of remotely and collaboratively creating music in real-time. We designed DuoRhythmo specifically to be utilized for eye tracking and optimized it for head- and computer mouse interaction, as well using a user-centered design approach. Together with five PALS, we completed a mixed-methods evaluation to assess the accessibility of DuoRhythmo. Participants described the CADMI using the Microsoft Desirability Toolkit (MDT) as fun, empowering, accessible, easy to use, engaging, and stimulating and gave an average System Usability Scale (SUS) score of 79.5. We suggest further research on remote collaboration within the field of accessible digital musical instruments (ADMIs) using the term CADMI to explore the positive effects of collaborative music-making on the quality of life of PALS.

OBJECTIVE: We explore the telehealth experiences of adults who use augmentative and alternative communication (AAC) and clinicians who work with people using AAC. MATERIALS AND METHODS: We conducted semistructured, online interviews with 6 adults who use AAC and 8 clinicians who provide telehealth services to people who use AAC between July and September 2020. Participants were located in the United States and the United Kingdom. All participants had engaged in 2 or more telehealth visits in the past 6 months. We used an inductive, thematic approach to analyze the interview data. RESULTS: Our findings reveal that (1) telehealth is an essential service, (2) technology causes barriers, (3) policies meant to protect actually inhibit, and (4) remote monitoring devices have the potential to mitigate risks. DISCUSSION: Telehealth systems created for persons without disabilities do not provide equitable access to everyone. Telehealth should be flexible enough to allow patients to use the communication modality that best meets their needs. We suggest that healthcare systems think of the healthcare ecosystem as one which includes a variety of telehealth options in addition to traditional in-person clinical visits. CONCLUSIONS: The benefits of telehealth for people who use AAC are substantial and should be an option for ongoing health care. However, the accessibility of telehealth technologies needs to be improved. Designers should view telehealth as part of a broad healthcare ecosystem, which includes in-person, telehealth, and remote health monitoring technologies. Designers should also include AAC users in the design and development process. Telehealth policies should encourage multimodality access to health care and address funding concerns.

Gaze-tracking technologies can enable computer access for users who are unable to use standard input devices. However, using gaze as input poses challenges for interactions that require visual planning, like playing a digital instrument. We explore how multimodality can support eye-controlled musical expression by designing different multi-modal gaze interactions around a digital instrument we call Dueto. We tackle three design goals: creating an instrument that is explorable, easy to learn, and allows feature controllability. We showcase three different multimodal interactions for music playing such as eye gaze only, gaze + switch, and gaze + partner mode.

Alternative and augmentative communication (AAC) systems used by people with speech disabilities rely on text-to-speech (TTS) engines for synthesizing speech. Advances in TTS systems allowing for the rendering of speech with a range of emotions have yet to be incorporated into AAC systems, leaving AAC users with speech that is mostly devoid of emotion and expressivity. In this work, we describe voicesetting as the process of authoring the speech properties of text. We present the design and evaluation of two voicesetting user interfaces: the Expressive Keyboard, designed for rapid addition of expressivity to speech, and the Voicesetting Editor, designed for more careful crafting of the way text should be spoken. We evaluated the perceived output quality, requisite effort, and usability of both interfaces; the concept of voicesetting and our interfaces were highly valued by end-users as an enhancement to communication quality. We close by discussing design insights from our evaluations.

Mental health disorders are a leading cause of disability worldwide. Although evidence-based psychotherapy is effective, engagement from such programs can be low. Mobile apps have the potential to help engage and support people in their therapy. We developed Pocket Skills, a mobile web app based on Dialectical Behavior Therapy (DBT). Pocket Skills teaches DBT via a conversational agent modeled on Marsha Linehan, who developed DBT. We examined the feasibility of Pocket Skills in a 4-week field study with 73 individuals enrolled in psychotherapy. After the study, participants reported decreased depression and anxiety and increased DBT skills use. We present a model based on qualitative findings of how Pocket Skills supported DBT. Pocket Skills helped participants engage in their DBT and practice and implement skills in their environmental context, which enabled them to see the results of using their DBT skills and increase their self-efficacy. We discuss the design implications of these findings for future mobile mental health systems.

For eye tracking to become a ubiquitous part of our everyday interaction with computers, we first need to understand its limitations outside rigorously controlled labs, and develop robust applications that can be used by a broad range of users and in various environments. Toward this end, we collected eye tracking data from 80 people in a calibration-style task, using two different trackers in two lighting conditions. We found that accuracy and precision can vary between users and targets more than six-fold, and report on differences between lighting, trackers, and screen regions. We show how such data can be used to determine appropriate target sizes and to optimize the parameters of commonly used filters. We conclude with design recommendations and examples how our findings and methodology can inform the design of error-aware adaptive applications.

Augmentative and alternative communication (AAC) devices are a critical technology for people with disabilities that affect their speech. One challenge with AAC systems is their inability to portray aspects of nonverbal communication that typically accent, complement, regulate, or substitute for verbal speech. In this paper, we explore the design space of awareness displays that can supplement AAC devices, considering their output features and their effects on the perceptions of interlocutors. Through designing prototypes and getting feedback on our designs from people with ALS, their primary caregivers, and other communication partners, we consider (1) the consistent tensions that arose between abstractness and clarity in meaning for these designs and (2) the ways in which these designs can further mark users as "other." Overall, we contribute a generative understanding of designing AAC awareness displays to augment and contextualize communication.

Gaze-based alternative and augmentative communication (AAC) devices provide users with neuromuscular diseases the ability to communicate with other people through only the movement of their eyes. These devices suffer from slow input, causing a host of communication breakdowns to occur during face-to-face conversations. These breakdowns lead to decreased user autonomy, conversation quality, and communication partner engagement. Attempts to improve communication through these devices has mainly focused on throughput and rate enhancement, though this has only attained meager results to date. In this work, we address this issue from the top down by considering AAC devices as a form of groupware and designing interactions around this groupware that facilitate better conversations for all involved communicators. We first present qualitative findings on issues with gaze-based AAC and end-user communication preferences; we identify several design guidelines for improving these systems and then present AACrobat, a system that embodies these guidelines and introduces novel interactions by extending gaze-based AAC devices with a mobile companion app. Finally, we present early feedback on AACrobat through three case studies of users with ALS.

Amyotrophic Lateral Sclerosis (ALS) is a disease that causes individuals to lose their ability to control their muscles, eventually leaving them unable to speak or write. People with ALS often transition to using an augmentative and alternative communication device (AAC), which requires both the AAC user and their conversation partners to adjust to new and different communication patterns. We conducted interviews with seven individuals with ALS and their partners, focusing on how AAC use has impacted their communication and personal expression. Our participants experienced a range of communication difficulties, including conversational pacing, personality expression, and interacting with unfamiliar conversational partners. Participants worked to adapt their communication behaviors to the AAC device, but still experienced challenges in expressing themselves, and sometimes felt compelled to withdraw from social interaction. By improving our understanding of how people transition to using AAC, we may inform improved designs for future AAC devices.

Remnance of Form is an interactive installation that explores the dynamic tension between an object and its shadow. By fusing light, projection, and motion technologies, the shadow can now detach itself from its former role. This creates a new narrative that challenges our perception of reality, what's real and what's not.

Smartphone use in presentations is often seen as distracting to the audience and speaker. However, phones can encourage people participate more fully in what is going on around them and build stronger ties with their companions. In this paper, we describe a smartphone interface designed to help audience members engage fully in a presentation by providing real time mobile feedback. This feedback is then aggregated and reflected back to the group via a projected visualization, with notifications provided to the presenter and the audience on interesting feedback events. We deployed this system in a large enterprise meeting, and collected information about the attendees' experiences with it via surveys and interaction logs. Participants report that providing mobile feedback was convenient, helped them pay close attention to the presentation, and enabled them to feel connected with other audience members.