This thesis explores how older people construct meaning, use and make sense of three kinds of robots in their homes. The exploration is undertaken in empirical studies of an assistive robot, an eHealth system, and robotic vacuum cleaners. The research draws on data collected through interviews and observations of older people in relation to three robots. The results show that older people’s domestication of robots cannot be condensed into one universal formula that fits all older people and all robots. The domestication of a robot is a process of constant shaping through negotiations with other people, other technologies, everyday life practice, society, and in relation to and with the robot and ourselves. For robots to be meaningfully and seamlessly integrated into older people’s everyday lives they need to be easy to use and desirable. But they also need to fit into the participants’ home practices. These include older person’s household activities, hobbies, interests, network of people, and the technology cluster in which the older person is situated. The usage of a robot needs to make sense to the older person; she needs to feel that she is in control of the robot and that the level of maintenance is reasonable. If the usage of a robot makes sense to the older person she will be willing to alter stable practices and routines. An important insight that emerged is how stereotypes of older people as weak, ill and housebound are embodied in robots intended for older people. These stereotypes are also constructed or reinforced by society, developers and older people themselves. The research presented demonstrates how this understanding of older people is situated in the home trials and shaped and maintained through them, which has powerful implications for the future development of robots. The findings further demonstrate that there is a difference between what older people say and what they do. The constructed and socially pervasive image of older people as weak, ill and housebound is apparent in how the older participants talk about robots and their potential. They incorporated robots into their everyday lives (as well as other technologies) that made sense to them, but they were unable to do so with robots that did not make sense to them. Instead the “practice of trying out a robot at home” ran parallel with the practices of everyday life during the home trials and became an end in itself. The main finding is not the serious implications of the stereotypical image of older people per se, but rather an understanding of how this stereotype is situated, shaped and maintained in the development. The thesis argues that by recognising the form older people’s participation and influence takes in current robotic developments, we can gain an understanding of the aspects that need to be scrutinised in order to find alternatives to current robotic developments.
This dissertation contributes to three fields within design research: - Explorations of a design space related to aesthetics of Tangible Interaction, which have led to a set of design imaginations as well as perspectives on salient design qualities. - Views on and a designerly example of knowledge construction related to Research through Design as well as to programmatic approaches to design research - Rich and reflected examples of how to co-develop design and pedagogy in the field of profound disabilities. Through the programme Tangible Participation the research seeks and expresses alternatives by critical questioning and imaginations of change. Such alternatives are articulated in a set of designs making the possible present. These designs have been part of collaborative questioning and imaginations in a long-term engagement with pedagogical praxes. Through this engagement, design and pedagogy have co-developed; and from this, the programme has matured and collaborative ways of criticality has been developed. The matured programme presented in this dissertation entails seven designs built and used in the pedagogical praxes as well as evolved framings able to generatively address a design space: a tangible interaction designer’s palette, a sensuous perspective, a compositional principle and potentials of tangibles for participation.
An activity-based vocabulary for Voice Output Communication Aids (VOCAs) was designed and evaluated through a user-centred, iterative design process, using expressions from the Gothenburg Spoken Language Corpus as well as other recorded, natural conversations. The growth and development of the vocabulary, called Phrases, was closely linked to its evaluation. The iterative design process included prototyping, collaboration with users, and modifications to the different versions of Phrases. The aims of the thesis were to investigate and visualise what goes on in interactions involving VOCAs, investigate the utility of a spoken language corpus in constructing AAC vocabulary, to evaluate the usability of Phrases, and to compare the effectiveness and efficiency of phrase creation to that of phrase selection. Four young adults with cerebral palsy, who used Augmentative and Alternative Communication (AAC), took part in the evaluation, as did sixty adults without speech impairments. The Phrases vocabulary was primarily built around pre-stored expressions for shop interactions and general quickfire expressions, including greetings, acknowledgements, feedback and expressions for communication management. It was tested in real and role-played shopping activities, and in an experiment. The results showed that phrase selection under certain circumstances can be faster than phrase creation, and that pre-stored phrases can enhance both the speed and enjoyment of VOCA-mediated conversations, providing that the users have learned where to find the expressions. The quickfire section was appreciated by all participants, but the activity shopping turned out to be of lesser importance to the four participants using AAC than was presumed from the beginning. Using a VOCA in a service encounter such as shopping turned out to be a complex undertaking for individuals with severe motor impairments. A model from Cultural-Historical Activity Theory provided useful insights into the contributing factors. The evaluations of the second version of Phrases gave valuable suggestions for the modification of future versions, such as making the activity structure more transparent, keeping phrases which were used while removing others, and adding new activities.
The purpose of the research presented in this thesis is to enhance the field of accessibility to include a multitude of perspectives. Based on cultural-historical activity theory (CHAT), it analyzes how human, artifactual and natural factors impact an individual’s possibilities to act in concrete situations that are part of a systemic whole. The thesis presents two main results: An enhanced accessibility encompassing: Epiaccessibility, accessibility’s spirit of the times, stands for how experiences of activities alter accessibility capacities, learning, expectations, attitudes, trust, demands and denials of the individual and her human, artifactual and natural environments. Lived accessibility, which includes the anticipations and the experienced conditions of a person to be able to do what she wants in a concrete situation. Planned accessibility, which consists of all the accessibility factors that can be created beforehand based on plans, guidelines and principles. The Activity Diamond, a model for accessibility: The Activity Diamond portrays a human activity system, where the subject-object relation is mediated and thus influenced by the human, artifactual and natural environments. The model is based on four interrelated sets of factors and is situated in time and place. Different actors with different activity systems may be involved. The model can be also used longitudinally in time. The thesis is based on a series of explorative studies in which the analysis unit is shifted from impairments and discriminatory factors in society to unique individual activity systems where humans, artifacts and nature together influence accessibility.
The thesis contains the following four papers: The Activity Diamond: a model for multifaceted I. accessibility. Status: Submitted to The Scandinavian Journal of Disability Research, May 5, 2009. An Activity Systemic Approach to Augmentative and II. Alternative Communication. Status: Submitted to the AAC Journal, July 24, 2009. Towards the Era of Mixed Reality: Accessibility Meets III. Three Waves of HCI. Status: Full paper presented at USAB 2009 (Usability & HCI Learning from the Extreme), November 10, 2009, usab.icchp.org. Submitted July 21, 2009. Accepted September 11, 2009. An activity theoretical approach to the International IV. Classification of Functioning, Disability and Health. Status: Submitted to Disability and Rehabilitation October 30, 2009.
This thesis describes the relations between objects, practices, and individuals. The main objective is to explore the role of artefacts in user-centred participatory design research, specifically for expressing and communicating personal experiences and creating meaning. In a broad sense I draw on experiences from three practices in order to define the scope of the thesis. The first is practice-led research, the second is design research specifically in the user-centred and participatory design traditions, and the third is concerned with the ways lay persons in general express themselves by and through objects and technology. The focus will be on the exchange of knowledge and experiences between two individuals: the researcher and the informant. One issue of interest is how communication can be made possible. Another is the use of artefacts for personal expression. A third is the constant balancing act when using the experiences and knowledge of a single or a few informants in design research.
The first half of the thesis is based on two design cases. Their common denominator is the exploration of how people can introduce their personal perspectives on their health situation into the medical context through the use of expressive artefacts. The first is a study of personal visualisations of experienced health (papers I, II). A future practice of routinely creating and using (instrumental) images based on emotions, meaning and subjectivity in rehabilitation and healthcare is proposed. The second case describes the development of a personal digital device, the Memory Stone used for storing and sharing personal and clinical information (papers III, IV). The case involves pregnant women but the device can be used wherever there is an interest in keeping personal diaries, handling medical information in novels ways, and interacting with information technology at home and in healthcare.
The second half of the thesis is an explorative venture grounded partly in the empirical work described in the first half, partly in extensive reading of literature from a wide range of disciplines. Three main areas have been included to discuss the relationship between humans, objects, technology, and self-narratives: a technology of the self (the self as image and data), a science of the self (autoethnography), and autobiographies. The intention is to set the stage for a critical and productive discussion on how the notion of autobiographic practice can inform and enrich design research methodology.
The overall aim of this thesis is to elaborate on the art of living with a traumatic spinal cord injury (SCI) in its relation to resources and norms in Swedish society. The thesis originates in part from a prevalence group of SCI individuals and is based on four studies. One is longitudinal and register based, and one is interview based. A paper on “ethics in the making” elaborates how general versus situated ethics might influence design. A norm perspective is applied in another study highlighting the double sets of social norms via narratives in the context of a severe disability. Through these approaches, I hope to open up an area in which little or no research has previously been carried out. A traumatic spinal cord injury is today not curable and commonly leads to a significant, permanent disability with a risk for severe complications. Living with a traumatic spinal cord injury poses, beside all the medical implications, a wide range of obstacles and circumstances in daily life that must be dealt with. The need for accessible environments and societal resources is thus obvious; an extensive and lifelong reliance upon such services will typically be established. The complexity of the injury and its effects on physical functions mean that the needs are great. Society provides various supportive services in order to restore social integration, re-establish autonomy, compensate for financial and functional losses and facilitate activities of daily living. Acute care, rehabilitation and readmissions both as inpatient and outpatient services are, of course, of great importance and are cost-consuming. Other services, though, will also be comprehensive due to their repetitive use in a life-perspective. The comprehensive aim of the thesis is formulated in the following sub-purposes: • Identify the spectrum of potentially relevant societal resources after traumatic SCI. • Investigate an incidence population’s use of societal resources including self-rated levels of satisfaction with the application process and resource allocation. • Discuss how general ethical guidelines are challenged by situated ethics in a design context. • Validate an existing inpatient register. • Analyze and discuss how a norm perspective can be utilized to understand why legislation is not sufficient to achieve Swedish disability policy goals. Results show that about 25 separate services are available and that each service has to be applied for separately by the individual. Information about the services was provided by a social worker but still individuals reported ignorance about the existence of various services. Applications were partially or totally rejected. The National Patient Register proved to be lacking information and was thereby validated by raising three questions: Is an inpatient stay registered in association with the injury date? Is the reported first length of stay plausible given the level and extent of injury? Are all the anticipated care and/or rehabilitation providers represented in the register? For 62%, the first registered hospitalization date correlated with the injury date, leaving 38% with a hospitalization that started later. Considering the level and extent of injury, individuals were reported to have unrealistically short initial hospital stays. The prevalence group visited 42 different hospitals and 47 clinics. Five rehabilitation clinics, though, were not reported. The study on double sets of social norms found that the individual’s experience in everyday situations runs contrary to the prevailing, expected norms. This results in the individual not being able to identify with everyone else or to rely on the current set of norms. The discussion elaborates on the time frame needed to perform and interpret longitudinal studies, as well as the impact different disability definitions have on the results. The use of the term “being in need of” in this area and how utilization can be estimated are also considered. The consequences of access to services being dependent on the individual’s initiative are examined. This section also highlights that the perspective of the authorities versus that of the individual (i.e. the lived perspective) are not only separate but different, and that the individual may be seen as a burden.
The following article reports result from an extensive study with 25 blind users from Italy and Sweden performed during the summer 2001. The tasks reported here test recognition of geometrical objects, recognition of VRML objects, mathematical surfaces and navigation in a traffic environment. The outcome of these tests show that blind users are able to handle also quite complex objects and environments, and that realistic virtual environments in some cases appear easier to handle than more abstract test environments. This highlights the importance of context, and thus the usefulness of other input channels beside the purely haptic one. Another factor observed to be important is haptic scanning strategy. Tentative results for age, gender and blindness from birth are presented, and the importance of accurate haptic models is pointed out.
This thesis is based on the Internet experiences of people with significant mobility/physical impairments who are proficient and experienced computer users in their computer world but have limitations in mobility that severely restrict their functioning in the physical world. The Internet functioning of this group is analysed by means of the factors attitude, control and enabling, with the main focus on what is achievable when all access problems such as unadapted interfaces, beginners? difficulties and the digital divide are overcome. If the virtual world is fully available but the real world is not ? what are the effects on learning, self image, communities of practice, sense of coherence, power and control? What are the effects on peer-to-peer learning and co-operation? Independent living concepts and theories manifest themselves throughout the thesis, most obviously, perhaps, in the selection of issues that are studied and in the perspectives. The theoretical background and concepts are those of disability studies, with a social model and independent living perspective, and with strong influences from rehabilitation engineering and design. Throughout the thesis elaborations and clarifications of the possibilities of interplay and co-existence between rehabilitation engineering and design and disability studies are made. Different aspects of function design and technology are examined from an expanded view on functioning, where technology is put in an individual and social context with the FACE (Function ? Attitude, Control, Enabling) tool.
Based on the results of two rehabilitation engineering design projects, this thesis aims to present and analyze: • What is required for genuine engineering knowledge and expertise to come into its own in rehabilitation engineering when the entire effort starts and ends with the person for whom it is intended. • How the work of an engineer not only can improve the conditions for the actual doing, but can also contribute to the understanding of situations and people, their capabilities, desires and needs.
The two projects, The Minimeter and Reading with Hands, are both based on and contribute not only to rehabilitation but also to the engineering context. My thesis comprises the work of an engineer from the earliest idea stage up to the final results that are first realized when the implementations are used by other people and can be assessed by them.
The Minimeter is a communication tool for people with severe brain injuries. It enables communication, starting at the yes-no level, for people with exceedingly limited mobility and extensive cognitive difficulties. Standard hardware combined with specially designed software is used to detect even minor movements and for example to make them steer a rolling ball on a computer screen. This yes-no interface inspires the user to act and yields continuous feedback and control.
Reading with hands is a system for computer based recording and automatic tracking of finger movements when reading Braille and in tactile picture recognition. It makes it easy to analyze the process and to draw conclusions, among them pedagogical ones with implications for future tactile reading training for children or adults who are blind. For the first time it is possible to automatically follow how the fingers move over the Braille text while the person is reading (aloud or silently). The finger movements can be compared to sighted persons? eye movements while reading standard print. Comparisons can also be made between the finger exploration of a tactile face picture by a blind person and the corresponding eye movements by a sighted person.
For people with central visual field loss, eccentric vision is all that they have to rely on. Even for those who learn how to correctly utilize their eccentric vision, it will never be as good as the central for two entirely different reasons: the off-axis optics of the eye can result in large refractive errors, and the low function of the peripheral retina. This thesis deals with the first of these factors: how to study and correct the eccentric aberrations in people with low vision by measuring the optics of their eyes, correcting the aberrations, particularly astigmatism, and evaluating improvements in visual functions.
The individual variations are large for both astigmatism and higher order aberrations such as coma. The main results of this research show that visual improvements through eccentric corrections are possible in spite of the retina’s poor function outside of the macula.
Eccentric optical correction affects both resolution and detection capacities. A person’s visual ability can also be influenced by their awareness and training of eccentric viewing.
This dissertation has three cornerstones: • Haptics • Human-Computer Interaction (HCI) • Blind Users
Haptics deals with controlling human movements and getting feedback through the sense of touch. A haptic interface transmits forces to a person’s hand or fingers in a way that mimics the sensation of touching real objects. Virtual haptic touch can be particularly useful for people with visual impairments. It makes it possible for a blind person to touch virtual objects, corresponding to the way a sighted person can see objects on a computer screen.
The goal of this research was to carry out an unbiased investigation of the potential of this technology for blind people. The more specific aims were to: • Investigate if and how blind people’s computer usage can be improved by virtual haptics. • Investigate the problems that arise with graphical user interfaces for blind people and how these problems can be managed with haptics. • Develop new applications and find new areas in which virtual haptics can be applied for blind people.
The design process has been primarily influenced by theories of usability engineering and reflection in action/reflection on action, focusing on the role of the engineer-designer. A concerted effort is made to use technology as a language to communicate with the users.
Several haptic interface devices have been involved. The Phantom from SensAble Technologies has been used the most. It is a small robot with a thimble or stylus attached to the tip which supplies force feedback to the user. The others are the FEELit Mouse from Immersion and the force feedback joysticks from Logitech and Microsoft.
Eighteen test applications were developed over five years’ time. They included games, curves, textures, drawings, menus, floor plans, and geometrical objects. Formal and informal user tests were performed on blind, blind-deaf and sighted people.
One of the key results presented are five guidelines for non-visual haptic interaction design for researchers, designers, testers, developers and users of such applications. The guidelines are: 1. Elaborate a virtual object design of its own 2. Facilitate navigation and overview 3. Provide contextual information 4. Utilize all available modalities 5. Support the user in learning the interaction method and the specific environments and programs
These guidelines represent the filtered and condensed knowledge and experience that the Haptics Group at Certec has gained during the testing and development process. They are further delineated and are a complement to existing HCI guidelines.
This work shows that there is great potential in using haptic technology in applications for blind people. It is viable to translate both 2D and 3D graphical information and make it comprehensible via haptics. It has been demonstrated that a blind person can orientate and navigate in a virtual haptic environment and that these tasks can be further supported by using complementary information such as sound and Braille. It is also possible for a blind person to use knowledge gained in the virtual world for real life orientation.
This dissertation concerns the field of applied psychiatry and focuses on the problems that are associated with the care and treatment of adult patients with autism spectrum disorders. The conditions that are described are valid for Swedish psychiatry and cannot be directly generalized to conditions outside of the country.
The research field of the thesis is clinical adult psychiatry and it focuses on the treatment of patients with autism spectrum disorders. Before the publication of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) in 1994 intellectually high-functioning patients with autism have not been included in diagnostic manuals and received appropriate treatment in adult psychiatry. In recent years it has become evident that these patients have long existed in psychiatric settings with other diagnoses than autism. This group of patients is poorly understood by their staff and the treatment they receive is seldom related to their specific difficulties.
The aim of the thesis is to contribute with theoretical and practical knowledge explaining the specific difficulties patients with autism have with contact, communication and cognition. Persons with autism have since early infancy not been able to profit from social learning and social interaction, which results in a psychological development different from normal developmental rules. Individuals with autism do not automatically include the perspectives of others in their communication and cognition. In psychiatric treatment it is normally taken for granted that all patients follow the same psychological rules.
Methods used are qualitative. A contextual analysis is made of eight psychiatric clinics, the staff members´ ideas about treatment, their understanding of their patients and their reorientation related to the patients with autism. Observations and semi-structured interviews are used in order to receive background information about the psychiatric contexts in which the patients with autism are treated. Learning theories about social learning in early infancy are used to explain the different psychology of adults with autism. Learning theories about adult learning are used when designing an education on autism. Documentation received by the staff members, describing their learning process, is analysed and put in relation to the results their learning had for the patients.
The staff of eight psychiatric clinics has received an education on autism, specially designed for their educational needs. The specific difficulties patients with autism have are explained. When alternative explanations are given to those of the autistic patient´s behaviours, which are regarded as problematic or enigmatic by the staff members, a reorientation process begins in the understanding of the patient.
Eight patients with autism are presented as case studies, giving examples of how the reorientation process of the staff members gives new perspectives to the patients´ problems and results in new treatment approaches. The results for most of the patients were spectacular – all patients, who had earlier had diagnoses other than autism, were better understood from the autism perspective. The need for re-diagnosis became apparent. All patients were better understood and received more individualized treatment after the education. One long-term patient was discharged after 25 years in forensic psychiatry.
This thesis deals with robotics and the new possibilities it offers people with physical disabilities. I focus on the user and the use of the technology and, in particular, on what makes robotic aids worth using - useworthiness as distinguished from usability.
User experience of the wheelchair-mounted Manus manipulator shows that robotic arms must meet technical requirements in terms of acceleration, speed, and pattern of movement. Easy horizontal and vertical adjustment of the end-effector is another requirement which must be met to enable a user to carry out the most common movements faster with less concentration./p>
Experience of the useworthiness of robots was first obtained through the development of page-turning end-effectors for the RAID workstation. The principles of separating pages and the page-turning movements are analyzed and described in this thesis. End-effectors are essential to the functionality and useworthiness of robots. The performance requirements for the automatic grasping function for simplified robot use have been brought out through user trials./p>
The thesis demonstrates that user trials with robots as assistive devices can result in new knowledge about both the use of the technology itself and the personal characteristics - needs, abilities, wishes, and dreams - of the user./p>
Parts of the thesis have already been published or will be published in the form of articles and conference papers: - Robotics in rehabilitation. IEEE Transactions on Rehabilitation Engineering, vol. 3, no 1, pp. 77-83, March 1995. - The Manus Manipulator as a Tool for Rehabilitation. To be published in the Scandinavian Journal of Rehabilitation Medicine. - Technical results from Manus user trials. Proceedings of the sixth International Conference on Rehabilitation Robotics (ICORR), pp. 136-141, Stanford, California, USA, July 1999. - Robot control methods and results from user trials on the RAID workstation. Proceedings of the fourth International Conference on Rehabilitation Robotics (ICORR), pp. 97-101, Wilmington, Delaware, USA, June 1994. - RAID - A Robotic Workstation for the Disabled. Proceedings of the 2nd European Conference on the Advancement of Rehabilitation Technology (ECART 2), pp. 24.3, Stockholm, Sweden, May 1993.