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configurations in assistive technology often lead to abandonment* [15], an especially
poignant fate considering that these sorts of systems may cost thousands of dollars.
Some experts estimate that as much as 70% [18, 23] of all such devices and systems
are purchased and not used over the long run, particularly those designed as a cogni-
tive
orthotic
[17]. Causes for abandonment have many dimensions; a study by Phillips
and Zhao reported that a “change in needs of the user” showed the strongest asso-
ciation with abandonment [21]. hus, those devices that cannot accommodate the
changing requirements of the users were highly likely to be abandoned. Although
this study did not address configuration issues directly, it follows logically (and is
confirmed by interviews with several AT experts [2, 14]) that an obstacle to device
retention is difficulty in reconfiguring the device. A survey of abandonment causes
lists “
changesinconsumerfunctionalabilitiesoractivities
” as a critical component of AT
abandonment [11]. A study by Galvin and Scherer states that one of the major causes
for AT mismatch (and thus abandonment) is the myth that “
ausersassistivetechnology
requirementsneetobeassessedjustonce
” [24]; ongoing re-assessment and adjustment to
changing needs is the appropriate response. A source for research on the other dimen-
sions of AT abandonment, and the development of outcome metrics to evaluated
adoption success, is the ATOMS project at the University of Milwaukee [22].
Successful AT design for this population must support, the interface require-
ments for users with cognitive impairments as well as view configuration and other
caregiver tasks as different and equally important requirements for a second-user
interface [7]. One proven approach applies techniques such as task-oriented design
[16] to mitigate technology abandonment problems. Research [9] and interviews
have demonstrated that complex, multifunctional systems are the most vulnerable
to abandonment due to the complexity of the many possible functions. herefore,
the initial goal was a simple system that does one (or few) things very well for a large
range of users/caregivers with an interface that is exceptionally easy to use initially.
7.2.2.1 Abandonment Based on the “Universe of One”
People with cognitive disabilities represent a “universe of one” problem [9] (see
Figure 7.1): a solution for one person will rarely work for another. he “universe of
one” conceptualization includes the empirical finding that (1)
unexpected islands
ofabilities
exist: clients can have unexpected skills and abilities that can be lever-
aged to ensure a better possibility of task accomplishment; and (2)
unexpecteddei-
citsofabilities
exist. Accessing and addressing these unexpected variations in skills
and needs, particularly with respect to creating task support, requires an intimate
knowledge of the client that
onlycaregivers
can provide [8]. Currently, a substantial
portion of all assistive technology is abandoned after initial purchase and use—as
*
here is another kind of abandonment, which is not using the system or device because the
need no longer exists. his “good” abandonment of AT is not in the purview of the current
study.
