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A Usability Evaluation of Workplace-Related Tasks on a Multi-Touch Tablet Computer by Adults with Down Syndrome

Libby Kumin, Jonathan Lazar, Jinjuan Heidi Feng, Brian Wentz, and Nnanna Ekedebe

Journal of Usability Studies, Volume 7, Issue 4, August 2012, pp. 118 - 142

Article Contents


Research has found that children and young adults with Down syndrome can use computers effectively (including the mouse, keyboard, and screen), often without any assistive technologies or modifications (Feng, Lazar, Kumin, & Ozok, 2008). The skills that individuals with Down syndrome need to use computers include fine motor skills, visual-motor skills, visual memory skills, letter recognition skills, reading and literacy skills, and, depending on how instructions are given to them, auditory and visual processing skills. Previous medical/clinical research has documented difficulties with fine motor skills and challenges with perceptual motor coupling (Bruni, 1998; Savelsbergh, van der Kamp, Ledebt, & Planinsek, 2000) in people with Down syndrome; however, multiple HCI data collection efforts related to children and adults with Down syndrome using computers do not show fine motor difficulties when using the mouse and/or keyboard. So, there appears to be a disconnect between the findings in the medical/clinical literature relating to difficulty with discrete fine motor tasks and the use of fine motor skills for computer input (Feng et al., 2008; Feng, Lazar, Kumin, & Ozok, 2010; Hu, Feng, Lazar, & Kumin, 2011; Lazar, Kumin, & Feng, 2011). For instance, children and adults with Down syndrome can use the computer mouse for input much more effectively than would be expected, based on the medical/clinical literature.

Generally, visual motor skills, visual processing skills, and visual memory skills are documented in the literature as strong avenues for learning for people with Down syndrome, whereas auditory processing and auditory memory skills are found to be relatively weaker channels for learning (Bull, 2012; Chapman & Hesketh, 2000; Fidler, Most, & Philosky, 2009; Jarrold & Baddely, 2002; Pueschel, Gallagher, Zastler, & Pezzulo, 1987; Shott, Joseph & Heithaus, 2001). Because the computer is often a visual medium, computer use has been found to be effective for communication and learning for people with Down syndrome (Burkhart, 1987; DeBruyne & Noecker, 1996; Meyers, 1988; Meyers, 1994; Romski & Seveik, 1996; Steiner & Larsen, 1994).

Before our ongoing research into the human-computer interaction (HCI) of people with Down syndrome, there were no research studies published that focused specifically on the population of users with Down syndrome. Studies in the HCI literature have included people with Down syndrome in the broader category of “people with cognitive impairments,” without noting their specific strengths and challenges (Dawe, 2006; Hoque, 2008). Individuals on the autism spectrum and individuals with neurologically based impairments have previously been included in the same analysis group in research as individuals with Down syndrome. Because individuals with Down syndrome have visual learning strengths, it is important to look at their performance separately from those with other cognitive impairments. It is also important to investigate computer usage in this population using a variety of research methods, rather than only one research method, which may lead to unintended bias (Lazar, Feng, & Hochheiser, 2010). It is possible that people with Down syndrome have higher performance using some HCI research methods than others, because with no history of using these research methods with these user populations, it is impossible to tell at this point if any biases are present.

There are a number of recent examples of studies involving technology usage by individuals with Down syndrome. For instance, Kirijian and Myers (2007) was a design case study involving people with Down syndrome in the design to help build online training modules. Another example was a survey study of 561 children and young adults with Down syndrome regarding computer usage (Feng et al., 2008; 2010). Another study reported on an ethnographic observation of 10 expert adult users with Down syndrome (Lazar, Kumin, & Feng, 2011). A further analysis examined the types of computer-related workplace tasks being performed by employed adults with Down syndrome (Kumin, Lazar, & Feng, 2012). A recent study used an experimental design that compared the effectiveness of a keyboard, a mouse, speech recognition, and word prediction for teens and young adults with Down syndrome (Hu et al., 2011). Although case study design, survey, ethnographic observation, and experimental methodology have been used to study computer use in the population, usability testing has not yet been employed as a method for investigation of computer use in people with Down syndrome.

Our previous studies have investigated the use of several input techniques by individuals with Down syndrome, including keyboard, mouse, speech recognition, and word prediction (Feng et al., 2008; Hu et al., 2011; Lazar et al., 2011). Our current focus is on computer skills in adults and how these skills can be used in employment. Touch-screen and tablet computers are increasing in workplace usage, and many employers are even purchasing these devices for employees (such as the iPad, Samsung Galaxy, and Blackberry Playbook). These types of devices are also widely used by people in non-work related settings. Consequently, not being able to use multi-touch tablet computers could not only result in fewer employment opportunities, but could also result in social exclusion, because people often share pictures and movies using a tablet computer or other mobile touch-screen devices.

A high level of mouse skills have been documented in both adults and children with Down syndrome (Feng et al., 2008), but it’s also worthwhile to investigate other forms of input devices, such as touch-screens. Theoretically, general touch-screen usage should be easier than mouse usage for individuals with Down syndrome, because a mouse is an indirect pointing input device, whereas a touch-screen is a direct pointing device, and therefore, less cognitive processing is needed (Greenstein & Arnaut, 1988). Also, when using a touch-screen for simple gestures (such as pointing, but not including multi-touch gestures), only one finger is used, versus the multiple fingers that are typically used for holding and guiding a mouse (Forlines, Wigdor, Shen, & Balakrishnan, 2007). In survey data from 2007 and 2008, 12.3% of children and young adults with Down syndrome were reported to be using touch-screens. This at first might seem low; however, it is important to note that touch-screen and tablet computing was much less prevalent in 2007, when the data was collected, before the introduction of the iPad. In the neurotypical community of users, a major increase in touch-screen usage during that same time period would also be expected (Feng et al., 2008).

Another aspect of touch-screen usage that is important to investigate is the on-screen (virtual) keyboard. Keyboard input can be challenging for many people with Down syndrome: while expert users with Down syndrome have some success with keyboard usage (Lazar et al., 2011), many more novice users only use one finger on one or both hands while typing, resulting in slow and error-prone keyboarding (Feng et al., 2008; 2010). It appears that having multiple keyboarding classes while growing up, in both K-12 education and post-secondary education, has a positive impact on keyboard typing skill level for adults with Down syndrome (Lazar et al., 2011). However, there is no current research on the use of touch-screen-based keyboards by people with Down syndrome. It is important to understand how people with Down syndrome can interact with a keyboard when it is only a visual keyboard on a touch-screen, without the tactile nature of a physical keyboard.


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