Cognitive Support Technology for People with Intellectual Disabilities: Factors for Successful Implementation
Abstract
:1. Introduction
2. Methods
2.1. Cases
2.2. Standard Work Plan
- Step 1
- Preparation
- Step 2
- Analysis and selection
- Step 3
- Development and implementation
- Step 4
- Evaluation
3. Case Descriptions
3.1. Assembly of an Electronic Unit (Case 1)
3.1.1. Set-Up
3.1.2. Outcome
3.2. Assembly of a Fan (Case 2)
3.2.1. Set-Up
3.2.2. Outcome
3.3. Cleaning (Case 3)
3.3.1. Set-Up
3.3.2. Outcome
3.4. Order Picking (Case 4)
3.4.1. Set-Up
3.4.2. Outcome
4. Discussion
4.1. Outcome of Cases
4.2. Limitations
4.3. Key Factors of Success
4.3.1. Selection
- One needs to have a clear view of the working conditions, the work processes and tasks, and the human needs for support. The task complexity as perceived by workers is an important aspect herein, also discussed by Wiedenmaier et al. (2009). Different conditions, processes, tasks, and needs may require different types of technology. For instance, smart glasses could be advocated for where workers are mobile, need two hands for task performance, and do not need too much information. Where workers are stationary and a lot of information is needed, on-site projection technology may be attractive. Touch-screen displays and tablets on which digital work instructions are communicated may work well in cases where multiple workstations need to be equipped, provided that these can be placed within view and their operation does not interfere with the performance of a two-handed job.
- The reasons for selecting specific technologies should be clear to all involved. The selection decision should be transparent and based on common understandings. This holds for the aim. CST may serve different aims like increasing productivity (work speed), increasing quality (reducing error), or increasing accessibility for ‘weaker’ groups. The aim could be to learn new jobs faster or to provide continuous support in daily operations. Consensus is not always self-evident. We also need common understanding on the target group of users of the technology, the worker’s needs, and in reaction to these needs, the pros and cons of different technologies. The organization of a dedicated workshop, such as that involved in our work plan (see Section 2.2), could be helpful to realize the above.
- Decision-makers should be included in an early stage. One may involve them in the dedicated workshop, where they could be informed and could contribute to the discussions. In our cases, decision-makers attended to the workshop or were properly informed from the beginning, except for in the cleaning case. In this case, we learned that a more expensive high-tech solution (like VR or AR) is not always necessary, and that a relatively simple solution that requires little investment can already bear fruit. Remarkably, this outcome did not meet the expectations of the decision-makers and thus the project stopped untimely.
4.3.2. Development
- The importance of a good working instruction cannot be underestimated, which has been argued before by Söderberg et al. (2014). One should be selective in the amount of information, not giving too little nor too much (Krause et al. 2022). Of course, the instructions should be easily understandable for the target users. It could be helpful to develop several levels of information, so one can adapt to the varying capacities of individuals. It certainly helps when the screen layout is consistent in where to show what. The amount of text should be kept to a minimum. Good and sufficiently detailed pictures (with annotations) or even short videos could be preferable above text blocks.
- The active involvement of workers to ensure that worker instructions really meet the worker’s requirements is crucial. As much direct worker participation as possible has been long advocated for within occupational interventions and is one of the main issues in Participatory Ergonomics (Noro and Imada 1992). This is based on the notion that technology developers cannot oversee the consequences and impact of their design decisions on the end users of the technology. This notion might even be stronger for workers that are intellectually disabled in one way or another, although obtaining meaningful feedback from these workers is more complex.
- The application of iterative cycles of development and testing with the end users is highly recommended. Iterative testing was applied in the assembly cases only, not in the order-picking case. Most meaningful feedback was retrieved after observing the end users while using the technology and interviewing them on the observed issue and deviations from instructions. Iterative testing in the assembly cases led us towards detailed refinements, as well as the decisions to make separate instructions for left-handed and right-handed people and two separate instruction levels: one for beginners and one for those who only needed part of the instructions after some experience. In the order-picking case, we just implemented the basic version provided by the technology producer. Hence, in this case, we ended up with some design recommendations, only after our evaluation.
4.3.3. Implementation
- The technology should be properly introduced to the workers. Vanneste et al. (2020) argue that when the supportive technology is new to workers, it can affect their performance, which can be alleviated by taking the time to explain its functioning at the beginning. Our experience with public social firms has found that a short explanatory introduction to workers with intellectual disabilities can be sufficient. This often works best with a follow-up, whereby the worker takes their time with the technical support to master the task. Supervisors do not need to stay close by, but should be available in case of questions. The dependency of workers on supervisors depends on the design of the interface. For instance, an initial video presenting the work process on a more general level before diving into each consecutive step might reduce the supervisor’s task.
- Cognitive support technology handles the technical explanation and guidance of the execution of the required working activities. With this target group, various factors other than the complexity of the task execution, mainly of a psychosocial nature, may stand in the way of performing well in the new task. If not addressed, the psychosocial factors may jeopardize all efforts to teach the technical task executions
- The role of the supervisor will change due to the technology. The technical explanation of the task execution and the training of it can be carried out through the technology for a significant part. It is clear, however, that the supervisor still needs to be there to support workers psychosocially. It is recommended to consider the modified role of the supervisor in the implementation stage.
- The adopting company should have or organize the capacity to master the new technologies. This includes the making of work instructions, but also the technical installation of hardware and the integration of CST software platforms into information or data-management systems that are used in the company.
- Finally, a wide commitment within the organization and a willingness to invest in terms of human capacity, time, and money in CST implementation are required to fully benefit from its potential.
5. Final Considerations
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Case 1 Assembly I | Case 2 Assembly II | Case 3 Cleaning | Case 4 Order Picking | |
---|---|---|---|---|
general | ||||
work | assembly of a product consisting of 37 actions, e.g., routing and connecting wires, using tools, and rotating the product | assembly of a product consisting of 24 actions, e.g., placing parts, routing of wires and quality control | multiple standard cleaning activities in various buildings of a school | picking orders consisting of 55 item types (clothes) from shelves into a picking bag |
technology | stepwise in situ-projected work instructions | stepwise work instructions on a tablet | communication tool and platform on a tablet | stepwise work instructions on a smart glass |
process steps | ||||
preparation | + | + | + | + |
analysis and selection | + | + | + | +/− work and needs analysis performed, no workshop to select the optimal system |
development and implementation | + multiple iterations of developing and testing with end users and team leaders | + one iteration of developing and testing and feedback by team leaders | − | +/− interface only marginally adjusted, no codesign with users |
evaluation | + 12 subjects 2 h | + 13 subjects 2 h | − | + 22 subjects 2 h |
test set-up | ||||
# subjects | 12 | 14 | − | 22 |
background job of subjects | simple assembly work | simple assembly work | − | simple assembly (6), packaging (6) and diverse work (4) and order picking (6) |
test duration | 2 weeks training and 6 weeks in real production | 2 h | − | 2 h |
Case 1 Assembly I | Case 2 Assembly II | Case 4 Order Picking | |
---|---|---|---|
accessibility | |||
technology effect on task demand vs. competence gap | Gap is reduced for all aspects of cognition and performance except reading gap unaffected for fine motor skills. | Gap is reduced for all aspects of cognition and performance except reading gap unaffected for fine motor skills. | Gap is closed, competences are estimated to outweigh task demands for nearly all aspects. Gap unaffected for fitness and stamina. |
number of workers able to perform the task | Nine out of twelve were capable to learn the task and started to work in real production. Two out of nine were successful in real production (7 dropouts). | Twelve out of thirteen were able to learn the task. Five out of thirteen showed potential to work in real production, another 5 ‘possibly’. | Twenty-one out of twenty-four were able to learn the task. For two people, eye-related problems—and for one, limited intellectual ability—formed a barrier. |
usability | |||
rating (1–10) | not measured | 7.8 | 7.9 |
positive quotations |
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negative quotations |
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acceptance | |||
preferences | Nine preferred the technology support. Two would have rather worked without this. One had no preference. | Nine preferred the technology support. One would have rather worked without this. Three had no preference. | Fourteen preferred the technology support. Four would have rather worked without this. Four had no preference. |
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Share and Cite
Looze, M.d.; Wilschut, E.; Könemann, R.; Kranenborg, K.; De Boer, H. Cognitive Support Technology for People with Intellectual Disabilities: Factors for Successful Implementation. Soc. Sci. 2023, 12, 622. https://doi.org/10.3390/socsci12110622
Looze Md, Wilschut E, Könemann R, Kranenborg K, De Boer H. Cognitive Support Technology for People with Intellectual Disabilities: Factors for Successful Implementation. Social Sciences. 2023; 12(11):622. https://doi.org/10.3390/socsci12110622
Chicago/Turabian StyleLooze, Michiel de, Ellen Wilschut, Reinier Könemann, Kim Kranenborg, and Harry De Boer. 2023. "Cognitive Support Technology for People with Intellectual Disabilities: Factors for Successful Implementation" Social Sciences 12, no. 11: 622. https://doi.org/10.3390/socsci12110622
APA StyleLooze, M. d., Wilschut, E., Könemann, R., Kranenborg, K., & De Boer, H. (2023). Cognitive Support Technology for People with Intellectual Disabilities: Factors for Successful Implementation. Social Sciences, 12(11), 622. https://doi.org/10.3390/socsci12110622