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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


All participants were able to complete the majority of the tasks in all five categories. Participants’ performance varied dramatically. The high-performers, such as P1 and P4, were able to complete all tasks at both high speed and high accuracy rates. Their interaction with the touch-screen interface was very similar to that of a neurotypical user. The participants who had a high typing performance were within the range of typical typing speed on touch-screen keyboards for users without Down syndrome (Findlater, Wobbrock, & Wigdor, 2011). On the other end of the spectrum, some participants, such as P2 and P9, had lots of difficulty with the tasks in every category and spent a longer time on each task, due to the spectrum of users involved. The total time that P2 and P9 spent on the tasks was three times of that of P1 and P4. The performance of the rest of the participants were somewhere in between the two extremes. Note that even though all of the participants had Trisomy 21 Down syndrome, there were clear variations in their level of speech and social interaction and a wide variety of skill levels, which is to be expected. The dramatic performance differences are most likely reflective of the dramatic differences between the participants themselves.

Some participants demonstrated attention to detail and made very few errors. This observation supports the medical/clinical research findings of increased obsessive-compulsive behavior characteristics (OCD) in some adolescents and adults with Down syndrome (McGuire & Chicoine, 2006). Some of the participants were more interactive than others. Some talked with the observation team as they were working and between tasks. Some told us stories in their own lives that related to the tasks and commented on the tasks. For example, P6 is the “weather reporter” for her family each morning, so she was familiar with looking up the weather. P10 engaged and talked continuously to us as he was working. P9 generally did not make eye contact with the researchers, talked only when asked specific questions, and took a long time to begin the task because she did not want to choose one friend to write to or make other choices. So, the longer times recorded for her task completion did not reflect difficulty with the task, but rather difficulty with decision making and social interaction.

Challenges and Opportunities

Switching from a desktop or laptop interface to the iPad touch-screen interface did present challenges to the participants. Although all participants had touch-screen experience, some had no direct experience with the iPad. It took participants a substantial amount of time to find and recognize specific icons on the apps interface. Because the icons on the iPad interface are generally smaller than those on the desktop interface, many participants failed to notice icons even when they were directly in front of them. They often scrolled up and down multiple times before they could locate specific icons. Because it has previously been noted (Lazar, Kumin, & Feng, 2011) that users with Down syndrome often look for visual icons (for network strength and battery life) due to their visual strengths, we postulate that it was the unfamiliarity with the icons that caused the problem. In several cases, we had to provide some participants with hints about the possible location or shape of icon(s).

Some participants had problems with the sensitive nature of the touch-screen and often accidentally tapped icons they didn’t want or clicked off windows or dialog boxes in the middle of a task, causing the desired window to exit/close (this was most prominent in the calendaring task that involved the scrolling selector). When this problem occurred, it took a while for the participants to realize what happened. It became frustrating for a few participants when this problem occurred repeatedly.

One area of challenge for users with Down syndrome was the small, and often unrecognizable, icons on the iPad. It might be interesting to research if other user groups (such as older users) have similar problems with the small and often cryptic icons. It could also be possible that icons that are at first cryptic, become more recognizable over time, and longitudinal studies involving users with Down syndrome might be helpful. Another area of research that seems fruitful is the use of touch-screen keyboards by people with Down syndrome, because typing patterns and approaches, as well as typing speed, was very diverse. Yet another potential area of research is doing Fitts’ Law-type studies of pointing speed and accuracy using multi-touch screens, because people with Down syndrome seem to be effective at pointing, yet the medical/clinical literature indicates that pointing would be difficult.


Many of the users who participated in this study exhibited a tendency to rely on or look for a search feature. For example, P1 used the search function to complete both Facebook tasks. P1 first searched the Facebook Web site using Google. Then she used the search feature in Facebook to find the NDSC page. Participants also used the search function extensively in order to complete the calendar tasks and the price comparison tasks. An easy-to-use search feature assisted users with locating information, and when this was combined with an extensive auto-suggest functionality, it increased the speed at which users were able to complete tasks. This is likely to result in lower levels of frustration and increased perceived capabilities on an interface. Providing multiple paths to the same goal is a key tenet of universal usability (Lazar, 2007). In the general population of users, some users will first use search boxes, and some users will first use menus, and expert users will often prefer command lines instead (Lazar, 2006). Both search boxes and auto-complete provide improved flexibility for all users, and in particular, may assist users with disabilities.

Another observation is related to security-focused interaction and functionality on interfaces. Users in our study were likely to have user accounts and passwords cached on their personal devices, and as such were not as familiar with the usernames/passwords necessary to log in from a different device, because that did not mirror their typical approaches for interaction. This is similar to the observations from previous studies on users with Down syndrome: Passwords are problematic and are often saved on the user’s computer so that they won’t need to enter the passwords (Feng et al., 2008). At the same time, the participants in this study had no problems when they encountered visual CAPTCHAs, similarly to the documented findings of (Lazar, Kumin, & Feng, 2011).

During the tasks that required messaging of some sort (social networking and email), it was also observed by the researchers that many users were much more adept and familiar with replying to incoming communications rather than initiating them (by composing a new message, for example).

Impact of Computer Training

Seven participants had taken computer related classes, while three (P2, P6, P9) had not. The three participants who did not take computing classes tended to have performance below the group average across the five categories of tasks, with the notable exception of P6 having above average performance on the email and Facebook tasks. This mirrors the pattern seen in other studies: that computer skills acquired through traditional, formal computer classes do have a big impact on performance for individuals with Down syndrome. In general, formal computer training has been decreased over the past decade, as younger adults (often known as the “millennial” or “digital native” generation) tend to use the exploratory approach, where they pick up a technology and learn by playing with it, rather than formal, procedural, training (Meiselwitz & Chakraborty, 2010). When it comes to information technology, it’s unclear whether people with Down syndrome benefit as much from exploratory learning, or whether formal procedural training would be more effective for people with Down syndrome.


One clear recommendation echoes the comments made in other publications: Formal computer training is especially important for users with Down syndrome. Users with Down syndrome need to take any opportunities for computer training that are available and make sure to continue practicing those skills. An area that continues to be problematic is password usage, and while users may save passwords on their home computers so that they can login quickly, this technique is often not allowed in the workplace, so users with Down syndrome need to be resolute in practicing and memorizing passwords for various accounts.

The design of interfaces and techniques that were often helpful to people with Down syndrome (such as search boxes and auto-suggest) are within the general category of universal usability and are helpful to many user populations. One exception that often does appear as a problem for users with Down syndrome is pull-down menus. For instance, multiple participants couldn’t find the logout on Facebook (which is located on a pull-down menu) and preferred to click the “X” to close the window. The fact that these menu options are hidden may be compounded by the fact that, unlike typical pull-down menus which are located on the left side of the screen, the Facebook pull-down menu is located on the right side of the screen. This problem with pull-down menus was noted as early as the case study of participatory design involving users with Down syndrome (Kirijian & Myers, 2007).

Visual learning, processing, and memory are strengths for people with Down syndrome, and because the iPad has myriad possibilities to use those visual strengths to successfully complete tasks in the workplace as well as in activities of daily living, educational policies, and guidelines should include formal classes to learn to use tablet computers. Transition planning from school to employment should include classes and internships that provide instruction as well as the opportunity to use computer skills. Assessment for employment through local, state, and federal rehabilitation/job training agencies should assess the level of computer skills, mouse, keyboard and touch-screen usage skills. Job placement currently does not frequently consider technology related skills for adults with Down syndrome. Research is now demonstrating that many adults with Down syndrome can use desktop, laptop, and touch-screen devices such as the iPad effectively, and that knowledge and skills need to be considered as policies regarding employment for adults with Down syndrome are developed and revised.


As previously noted, research has shown that individuals with Down syndrome can effectively use computers (Feng et al., 2008), and the results of this study confirm that at least a selected group of individuals with Down syndrome have the capability to use a multi-touch-screen device to complete office related tasks. Computer related training can help people with Down syndrome learn how to use an unfamiliar device. The high level of competency that the users exhibited in this study reveals much about the underutilized potential of this workforce-capable population of users. The ease with which most of the users interacted with a touch-screen also might suggest that a touch-screen could be used as a form of assistive technology, particularly when many desktop computers now have the option to be configured with this feature. The capability observed in this study is particularly encouraging because the majority of the participants had little or no experience using an iPad (but at least basic experience using a touch-screen) before the study. We expect that, with more training, the performance of the participants (especially those in the middle of the spectrum) could be substantially improved.


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