Informing Technology Design for Neurodivergent Users

Understanding How Sensory Changes Experienced by Individuals with a Range of Age-Related Cognitive Changes can Effect Technology Use

I further delved into the sensory changes experienced by individuals across the spectrum of age-related cognitive changes by conducting additional interviews with individuals with subjective cognitive decline and mild cognitive impairment. This extended version of our original paper, takes a step towards bridging the emerging clinical research concerning the different sensory changes people with age-related cognitive changes experience and the body of research aiming to design cognitively accessible technologies [Dixon, Anderson, and Lazar, 2022].

The Role of Sensory Changes in Everyday Technology use by People with Mild to Moderate Dementia

Research to date has focused primarily on the effects of cognitive changes due to dementia on technology use. Yet, there is clinical research and dementia activism that recognizes that people with dementia also experience unique sensory changes beyond what might be expected for normal aging. To understand how the sensory changes people with dementia experiences affect technology use, I reanalyzed 11 interviews with people with dementia from my previous work and conducted an additional 19 interviews with practitioners who work primarily with people with dementia. Through this analysis we uncovered three strategies participants utilized to accommodate changing sensory experiences in everyday life: 1) stimulating at a desired level, 2) adjusting technologies using built-in settings, and 3) switching devices [Dixon, 2020]. When these strategies were inadequate, this led to people with dementia ceasing to use certain devices. This work resulted in new directions for the design of technologies for people with dementia, including intentional sensory stimulation to facilitate comprehension, as well as opportunities to leverage advances in technology design for people with other disabilities for those living with dementia. This paper received the Dean’s Award for Outstanding iSchool Doctoral Paper and a Best Paper Nominee at ASSETS’20.

HCI researchers are increasingly attending to the ways that the values of various stakeholders make their way into the design and evaluation of technology. Identifying the often conflicting values of stakeholders helps us to reflect on and address the values we prioritize in the technologies we design. This is especially important in dementia, as other stakeholders, who may have contrasting values, are often given the power to make choices and exert agency over these individual’s health and technology use.  One major stakeholder in the dementia context are the practitioners who care for people living with dementia. I interviewed nineteen practitioners, finding they had contrasting epistemological views of dementia which affected how they interacted with their clients and facilitated technology use. Further, when researchers in HCI work with practitioners to design future technologies for people with dementia these views may be embedded in technologies designed with their assistance. In this paper we encourage technology designers to identify their own perspectives towards people with dementia concerning concepts such as infantilization, respect and self-actualization. In doing so, we advocate for perspectives that prioritize dignity and respect, while recognizing and caring for the needs of practitioners trying to operate within the existing system [Dixon, 2020].

Another major stake-holder to consider are the technology designers themselves. With minimal public health education concerning dementia, designers are left to their own often inaccurate understanding of dementia, leading to technologies designed for use by people with dementia which are stigmatizing and dehumanizing. For this reason, in my past work we developed and iteratively tested a modified user-centered design process, which incorporated a human-rights based approach [Chopra, 2021]. Through two iterations of a three-day-long design workshop, including undergraduate students and people living with dementia, we used this modified user-centered design process to teach undergraduate students in computing how to design technologies with considerations for users’ basic human rights [Chopra, 2021]. These workshops provided technology designers and developers in HCI with practical ways to incorporate human rights into the design of technologies for all people, regardless of disability.

The purpose of this study is to observe how dementia technology is talked about in the context of dementia related conferences. The goal is to gain a further understanding of the perspectives of people with dementia and those working with them on the technologies available for the aging population. Additionally, this work is allowing us to map the state of the art of technology design for dementia.

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