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AbleChat: Development of a chat app with pictograms for People with Intellectual Disabilities



People with intellectual disabilities (PID) are one of the target groups who might have problems to participate in the digital society because of limited literacy skills. For this target group, the Able-to-Include project ( developed an Accessibility Layer (AL) that can be integrated into existing or future ICT tools. This article describes the development of a chat application (AbleChat) for an Android Smartphone, which uses the AL to translate written text into pictograms. This allows PID to create messages using pictograms and caregivers to write in plain text. PID were actively involved in the design process, in the development process and the testing of the application. Along with PID, their caregivers were also involved. For, as communication partner of PID, they are important stakeholders. In a first phase, the context of use and user requirements were described, based on interviews with PID and their caregivers. Based on these findings, a first prototype was developed. This prototype was evaluated by the caregivers. A second version of the AbleChat was tested in a pilot study by 25 PID. After six months, both the caregivers and the PID were asked to evaluate AbleChat. Caregivers filled in a questionnaire based on the " App Evaluation Rubric ". Users were asked about their experiences and findings through a semi-structured interview. Both PID and their caregivers are excited about the concept of sending messages using pictograms. Nevertheless, there is a desire to extend the application and allow sending messages to friends and relatives. This feature and comments relating to the usability of the interface are integrated in the development of the final version.
AbleChat: Development of a chat app with
pictograms for People with Intellectual Disabilities
Jo Daems1, Nele Bosch1, Steven Solberg1, Jan Dekelver1, Marina Kultsova2
1K-Point, Thomas More University College, Geel, Belgium
jo.daems,, steven.solberg,
2 Volgograd State Technical University, Volgograd, Russia
AbstractPeople with intellectual disabilities (PID) are one
of the target groups who might have problems to participate in
the digital society because of limited literacy skills. For this target
group, the Able-to-Include project (
developed an Accessibility Layer (AL) that can be integrated into
existing or future ICT tools.
This article describes the development of a chat application
(AbleChat) for an Android Smartphone, which uses the AL to
translate written text into pictograms. This allows PID to create
messages using pictograms and caregivers to write in plain text.
PID were actively involved in the design process, in the
development process and the testing of the application. Along
with PID, their caregivers were also involved. For, as
communication partner of PID, they are important stakeholders.
In a first phase, the context of use and user requirements were
described, based on interviews with PID and their caregivers.
Based on these findings, a first prototype was developed. This
prototype was evaluated by the caregivers. A second version of
the AbleChat was tested in a pilot study by 25 PID. After six
months, both the caregivers and the PID were asked to evaluate
AbleChat. Caregivers filled in a questionnaire based on the “App
Evaluation Rubric”. Users were asked about their experiences
and findings through a semi-structured interview. Both PID and
their caregivers are excited about the concept of sending
messages using pictograms. Nevertheless, there is a desire to
extend the application and allow sending messages to friends and
relatives. This feature and comments relating to the usability of
the interface are integrated in the development of the final
Keywords—People with Intellectual Disabilities (PID); Human
Centered Design; Chat Application; Pictograms; Smartphone
For developers and engineers, it is a challenge to make
technology accessible to a broad audience. During the last
decades of the previous century, specific applications were
developed for people with disabilities. Today, there is an
increasing search for a more inclusive way of designing:
'Universal Design' and 'Design for All' 1. It is not easy to make
applications accessible for everyone. Apps and websites that
make use of written language are exemplary for this. People
with intellectual disabilities (PID) are one of the target groups
who have problems to participate in the digital society because
of limited literacy skills. For this target group, the Able-to-
Include project2 developed an Accessibility Layer (AL) that
can be integrated into existing or future ICT tools. This AL
uses three technologies: Simplext (simplified text), Text2Picto
(translation from text to pictograms and vice versa) and
Text2Speech (from written to spoken text). The AL is tested in
three different applications in three countries (Belgium, Great
Britain and Spain).
The AbleChat application, developed for an Android
Smartphone, uses the AL to translate written text into
pictograms. This allows users with literacy problems to chat
using pictograms and caregivers to write in plain text. The AL
takes care of translation. This way, AbleChat allows PID to
create messages independently via the smartphone and send
and receive messages in an understandable way.
AbleChat is designed for PID. They were actively involved
in the design process, in the development process and the
testing process of the application.
The American Association on Intellectual and
Developmental Disabilities (AAIDD) defines Intellectual
Disability (ID) as “a disability characterized by significant
limitations both in intellectual functioning and in adaptive
behavior, which covers a range of everyday social and practical
skills. This disability originates before the age of 18 ” [1]. The
definition by the American Psychiatric Association is
comparable: “Intellectual Disability is a disorder with onset
during the developmental period that includes both intellectual
and adaptive functioning deficits in conceptual, social, and
practical domains” [2]. “Intellectual functioning refers to
general mental capacity, such as learning, reasoning, problem
solving, and so on. Adaptive behavior is the collection of
conceptual, social, and practical skills that are learned and
performed by people in their everyday lives. For example:
language and literacy, money, time and number concepts
(conceptual), interpersonal skills, social responsibility, self-
esteem, social problem solving, the ability to follow rules/obey
laws and to avoid being victimized (social), personal care,
occupational skills, healthcare, travel/transportation,
schedules/routines, safety, use of money, use of the telephone
(practical)” [1]. “Four levels of severity are defined on the
basis of adaptive functioning, and not IQ scores, because it is
adaptive functioning that determines the level of supports
required. Moreover, IQ measures are less valid in the lower end
of the IQ range” [2]. Taking into account the description of the
severity levels, people with moderate or severe intellectual
disability are considered the primary target group for the use of
AbleChat. For people with moderate ID it’s shown that, all
through development, the individual’s conceptual skills lag
markedly behind those of peers. For adults, academic skills
development is typically at an elementary level, and support is
required for all use of academic skills in work and personal
life. Spoken language is typically a primary tool for social
communication but is much less complex than that of peers.
For people with severe intellectual disabilities, attainment of
conceptual skills is limited. The individual generally has little
understanding of written language or concepts involving
numbers, quantity, time, and money. Spoken language is quite
limited in terms of vocabulary and grammar. Speech may be
single words or phrases and may be supplemented through
augmentative means. Speech and communication are focused
on the here and now within everyday events. Language is used
for social communication more than for explication.
Individuals understand simple speech and gestural
communication [2].
The categorization should thus not be too strict, as ones
skills are also influenced by the developmental opportunities
provided by their environment during their lifespan. The target
users with poor reading or writing skills will benefit most from
the Accessibility Layer, as it specifically integrates
technologies that support these skills. People with better
reading or writing skills will probably not be as interested as
they will not need language support (as much). Users with
unclear speech can also be included, as AbleChat enables them
to communicate.
The principles of human-centered design were used during
the design process. Human-centered design [3] is described as
"an approach to interactive systems development that aims to
make systems usable and useful by focusing on the users, their
needs and requirements, and by applying human
factors/ergonomics, and usability knowledge and techniques.
This approach enhances effectiveness and efficiency, improves
human well-being, user satisfaction, accessibility and
sustainability; and counteracts possible adverse effects of use
on human health, safety and performance. The term “human-
centered design” is used rather than “user-centered design” in
order to emphasize that this part of ISO 9241 also addresses
impacts on a number of stakeholders, not just those typically
considered as users. However, in practice, these terms are often
used synonymously.” There are four linked human-centred
design activities that shall take place during the design of any
interactive system: understand and specify the context of use;
specify the user requirements; produce design solutions and
evaluate. During the development of AbleChat we
implemented these concepts and found additional methods and
tools as suggested by Maguire [4]. Experiences with a previous
project were included [5] [6].
PID are the primary stakeholders. Their involvement in the
design process is necessary, in particular to understand the
context of use and the user requirements. The evaluation
process takes into account the conceptual and academic skills
of the target group. Along with PID, their caregivers are also
involved. As communications partner of PID, they are
important stakeholders.
A limited desk research showed that some authors make
references to the user group of PID in certain areas but a fully
documented human-centered design method for this target
group could not be found [7] [8] [9] [10].
In a first phase, the context of use and user requirements
were described. This was based on interviews with PID who
were already using the Viamigo mobility app [5] on the
smartphone. Their caregivers were asked to observe the PID
while using Viamigo and the smartphone. Based on these
findings, a first prototype was developed: AbleChat (first
design solution). This prototype was evaluated by the
caregivers. Then, a second version of the AbleChat was
developed (second design solution). This was tested in a pilot
study by 25 PID. After six months, both the caregivers and the
PID were asked to evaluate AbleChat. Caregivers were invited
to fill in a questionnaire based on the “App Evaluation
Rubric” [11]. Users were asked about their findings through a
semi-structured interview that determined their experiences
and findings.
A. Context of use
When a system or product is developed, it will be used in a
certain context and it will be used by a user population with
certain characteristics. They will have certain goals and will
wish to perform certain tasks. The system will also be used
within a certain range of technical, physical and social or
organizational conditions that may affect its use [4].
Initially, AbleChat was meant to give PID information on
their travel while using the Viamigo app. The Viamigo app
offers people with an intellectual disability the opportunity to
travel more independently. The PID has a smartphone with the
app installed. He/she selects - with or without the help of the
caregiver or parent - the travel route he/she is going to follow.
When the PID starts to travel, the app sends a message that
he/she has started his route. The app periodically checks
whether the selected route is still being followed and whether
the current speed is still within the expected bounds given the
preset means of transport. The app sends a message to the
caregiver/parent when the selected route is not followed. The
caregiver or parent can then consult the PID's current location
on the Viamigo website and take appropriate actions, such as
calling the person on his/her phone. Communication between
caregiver and PID is not possible with the current Viamigo app
itself. The caregiver can only communicate with the user by
using conventional methods like sending a text message or
calling. The Viamigo app does allow the user to call their
caregiver with a single button press when travelling. The app
sends a message to the user when the caregiver has given
permission for leave (a smiley face) and when he user arrives
(an arrival flag). No other messages are sent to the user.
In the first instant users of the Viamigo app and their
caregivers were asked to answer a questionnaire in order to
gauge whether it would be advisable to add the Accessibility
Layer to the Viamigo app. This way, automated generated
messages, that at this time, only gets send out to the caregiver,
could be translated for the user as well by showing a simplified
version of the generated alerts as pictograms on the user’s
1) Survey of current Viamigo users
The 21 users were presented with a questionnaire that was
read through and filled in with one of the researchers. This
questionnaire was a part of a general satisfaction research about
the use of Viamigo. Users state their contentment about the use
of Viamigo and that they haven’t run into big difficulties while
traveling. If they did run into a problem, they were either
contacted by their caregiver, or their caregiver would meet
them. They had a hard time imagining receiving messages
about this themselves. In answer to the question if they would
like to be able to do more with their phone, 7 users stated they
would like to learn how to send messages using the
smartphone. Most of them stated that this would be difficult as
they cannot read and/or write that good. 13 stated they did not
want to learn this as they cannot read or write, 1 user can send
a text message himself. Learning how to call using the
smartphone is a goal for 8 users.
2) Survey of caregivers
Caregivers were asked whether it would be advisable if the
users would receive the automatic generated messages
concerning their travels themselves but also if other messages
could be included with Viamigo.
Caregivers note that the use of the Accessibility Layer
together with Viamigo should not become too complex for the
user. The apps should give more comfort to the user and this
should lead to autonomy. It is to be avoided that a smartphone
becomes a factor of stress during travels. Users could panic or
become confused when they receive a message about a detour
from the regular route (for example the bus takes a detour) and
they are not able to understand this message or they cannot take
any action. In addition caregivers note that users are taught to
carry their smartphone in their coat pocket, bag or backpack
during their travels. As a result it could be dangerous if they
want to view their messages while on the road, for example on
the bike or while crossing the road. Finally, it is noted that
users at this time do not have to perform a lot of actions on the
smartphone (open an app and select the picture of the path to
be taken) and that new applications should be both useful and
In concern of communication from the system to the user
(automatic generated) it was noted that “call your caregiver”
(in case the user left the path for a longer period, in case the
user has fallen, …) could be added. On the other hand it is
stated that this is a redundant function: the caregiver
automatically gets a message if a problem should occur and
will get in contact with the user. It was pondered if the message
“you are almost there” would be confusing rather than
encouraging. In case this message was generated right before
the last bus stop, and the bus would follow a detour, this
message would give the wrong signal.
The caregivers convey that next (pictogram-) messages
from the user to the caregiver could be usefull: for example “I
need help, Can you call me?”, “I’m waiting for the bus, the bus
is late, …”
Examples of useful messages from the caregiver to the user
are: “Stay where you are, I’m coming, Everything OK?, Do
you need help?, Call me, Ask someone to help, show your help
card.” Sending messages can be useful if one knows the user is
at a busy place when it can be difficult to use the phone and to
understand what is being said (for instance in a station, on the
bus, ….).
B. User requirements
User requirements provide the basis for the design and
evaluation of interactive systems to meet user needs [3]. For
PID, it is difficult to specify their needs about a smartphone
communication app, when they don't have experience with a
smartphone or with sending and receiving messages. As they
have difficulties with conceptualizing, it's hard to imagine what
this technology can mean.
It is for this reason that it is important to create moments
during the development stage to give PID the possibility to get
to know the application and to learn to use the application and
to test the usefulness in a later stage. Hence, the development
should be divided into more stages.
It is also necessary to take into account the following
usability requirements for the application: Effectiveness,
efficiency, satisfaction, intelligibility, understandability,
learnability, operability or supportiveness, flexibility and
attractiveness. These aspects will be monitored and evaluated
in several stages [4].
C. First design solution
It was considered that the users would benefit more from a
general purpose chatting app that allows them to communicate
with their caregivers without associating that communication
with stressful situations. Instead of using the accessibility layer
to resolve unforeseen events during a user’s travel it was
decided there should instead be a focus on empowering users
and providing them with a separate tool to communicate with
their caregivers in a day-to-day setting. When an event occurs
during traveling, the caregiver is informed and given the option
to also inform the user. The caregiver can assess the situation
and severity to make a well-informed decision instead of
having the app making these decisions. Instead of integrating
the accessibility layer in the Mobility app a new standalone app
will be developed. This app will be used alongside the Mobility
app and users will be trained in the use of both.
These conclusions were included in a brainstorming session
with the Able to Include partner Teamnet (RO). This session
resulted in the following features: 1) Communication between
user and caregiver, 2) Web application, allows caregivers to
customize the pages, 3) Display caregiver profile images, 4)
Communication between users, 5) User friend list.
Conversations between users will not be supported in the first
version. The primary reason is that the need for moderation is
unclear. Conversations between a user and his caregivers can
be moderated by the caregivers themselves and any confusion
or ambiguity can be resolved by the caregivers. This is not
necessarily the case during a conversation between users.
Secondary reason for not supporting this feature is uncertainty
regarding the demand for the feature. Feature 5 was left out due
to time constraints and uncertainty around their importance.
The new smartphone application (AbleChat) and
supporting website were prototyped.
1) Technical details
The mobility app already required Android devices, so for
the pilot, the new app was developed specifically for Android
4.1. and up as well. PhoneGap was considered, but was
rejected due to the learning curve being too high for the
available amount of time and the limited benefit for this
The new app would serve mainly as a proof of concept and
as a facilitator for the pilot. This meant that features that would
have been 'nice to have' would not be implemented during the
first iteration. Especially if these features required a backend
and web application to be developed as well.
Initially the content for the app would be driven by the
accessibility layer and picto databases. All pictos would be
grouped into categories and displayed as such. We opted for a
different approach since we figured this would overwhelm the
user. The sheer amount of pictos is simply too large to display
and navigate efficiently on a smartphone. Even more so when
the user has very little experience with using smartphones in
the first place. Instead of relying on an automated system, we
decided letting caretakers choose and organise pictos in
cooperation with their user would be more suitable.
Caretakers can customise the pages for each user
individually by using an online editor. This editor leans on the
concept of pages and buttons to build the interface the user will
see on their phone. The user always sees a single page with
certain amount of buttons. Each button can be programmed to
add a specific picto to the message that may be sent later or to
navigate to a different page. This allows caretakers to gradually
add pages as the user become more adept in using the app.
Customizing pages, however, required a backend. We were
quite certain that not implementing this feature would
jeopardise the success of the pilot for previously mentioned
reasons. A backend was built by reusing sources from a
previous Java EE - JSF project and is hosted on a JBoss
Application Server. This backend provides the smartphone
application with data through a basic restful json api.
2) Chat app description
The AbleChat application will allow PID to talk with their
caregivers by using pictograms. The app consists of a
smartphone app for Android devices and a web application.
The smartphone app will be used by both users and caregivers.
The web application will only be used by caregivers to
customize the user experience.
a) Web application
In order to be able to use AbleChat, having an account on
the web application is required. The caregiver starts by
registering an account. Assigning a user (called client on the
website) to a caregiver (and his organization) will add the user
to the caregiver’s dashboard and enable him to customize the
user’s smartphone app.
The appearance and result of every on-screen key on the
user’s smartphone app can be altered by the caregiver, together
with the PID, on the website. Beta and Sclera pictograms,
provided with a corresponding text, can be chosen. The number
of pictograms can change over time, as they get more
In addition, there is also the possibility to upload an image.
Caregivers can select pictograms based on the interests and
pursuits of the client. Also the number of on-screen keys
displayed on the smartphone of the user, the color of the keys
and its action (adding the pressed pictogram to message being
constructed, navigating to another page or calling a specific
caregiver) can be determined individually, as well.
b) The smartphone app
The smartphone application can operate in either client or
caregiver mode. This means there are no separate apps for
users and caregivers. This mode is determined during the apps
first use and can only be changed by resetting the app to
prevent clients from changing the setting.
Client mode limits the app to a single interface. The user
only sees a short history of sent and received messages and
controls necessary for sending messages. The user does not
have to select which caregiver will receive a message. This
approach was taken to minimize the complexity of the app and
the chances of a user not getting an answer due to the receiving
caregiver being absent. Instead messages are sent to all
assigned caregivers. This transparency allows a caregiver to
follow up and take steps if the intended recipient fails to
respond in a timely fashion. Users can only send messages
using the provided pictograms, but as these pictograms are
selected especially for them, they are all meaningful.
In caregiver mode, besides the chat functionality the
caregiver will be able to see a list of users assigned to him.
Selecting users from this list will allow the caregiver to send
messages to them. Upon receiving a message from any user
from his organization (to which he is assigned on the website),
the device will display a notification and require the caregiver
to acknowledge the message.
For every message the caregiver receives, a description is
added to each of the pictograms in addition to the pictograms
the user has used to form his message. These descriptions are
the result off an algorithm developed by KU Leuven [12]. The
algorithm returns the descriptions that form the most
meaningful or appropriate sentence.
Sending a message with the app in caregiver mode is very
similar to sending a standard text message. Whenever the
caregiver finishes typing, the app will translate the provided
text into their pictogram equivalent. The caregiver can then
decide whether the translation is accurate enough and send the
message or correct the provided text and try again. Sometimes,
changing the sentence is advisable for a better translation.
Quite some emphasis has been placed on predictability. The
app has been designed in a way to prevent sending ambiguous
or confusing messages whenever possible.
D. Evaluation of the first desing
Caregivers state that the difference between send and
received messages is not clear enough. Both are rendered in the
same background colour. The message send by the caregiver is
the only one that is preceded by a picture. The grey ‘send’
button is not discernible enough. It is not clear that the purple
key locks/unlocks the screen. The sound that indicates a new
message has arrived, is not loud enough. The question has
arisen to, when a message arrives, not only to show a picture of
the caregiver, but also of the user. Overall, it has been agreed
that it is not necessary that all caregivers receive all message
send out by PID in their care. It would be good if the user
would be able to send personal messages to his caregiver, and
to his familymembers (sister, brother, parents) and friends
(inclusive other PID).
E. Second design solution
Given that the first design was not tested by PID only small
adaptations were made to the first prototype.
The difference between send and received messages will be
indicated with different background colours (yellow and blue).
The send button will get a purple colour, comparable with the
colours of the Able-to-include logo. The key to open the
keyboard will be expanded with arrows. The volume for
incoming messages is louder. The request to enable the user to
send (personal) messages to friend and individual caregivers
will be included in the next version.
Fig.2. AbleChat, preview of the keyboard, client mode (left), caregiver mode
(right). In this preview, the caregiver chose Beta pictograms.
Fig.2. AbleChat, preview of messages, user (left), caregiver (right).
F. Evalution of the second design
The second design solution was tested in a pilot study by 25
PID and their caregivers, linked to 6 organizations that provide
services to PID.
The pilot was carried out during 6 consecutive months
(September 2015- February 2016) in order to test its validity
and its conformity to the needs of the users. This first round
was followed by a period of 4 months of modifications and
improvements of the accessibility layer in order to fix any
problem that appeared and to take into account improvements
suggested by the users.
An application was submitted to and approved by the
Ethics Committee of KU Leuven (G-2015 10 368). An adapted
Informed Consent form for people with IDD (supported by
pictograms) and an Informed Consent form for legal guardians
and caregivers were handed out during the first training session
for caregivers and were collected during the next sessions.
The training and the collection of the feedback was done in
several steps.
1) Training of caregivers and users
Step 1, Introduction on AbleChat: 20 caregivers
attended this session.
Step 2, Subscription of 25 participants: 14 men, 11
women, age range between 18 and 65 years.
Smartphones were made available by Thomas More, K-
Step 3, Training session for caregivers on the use of
Ablechat (website and apps, accounts for caregivers and
users, use of manual, installation of apps): This session
was given four times, each time for a small group of
caregivers. During this session, 8 devices with different
interfaces set up were demonstrated. Some of the
devices only had a Home page with 6 pictograms,
others had homepages with 9 or 12 pictograms or had
the option to navigate between subpages with
pictograms. Based on these examples, caregivers could
set up a personalized profile for each of their users.
Therefore caregivers needed to think about the
messages their user would like to send, about the
pictograms they need for this, how navigation should
look for the user, how to organize the didactical
approach, …This profile may contain one (home page)
or more pages (subpages) with Beta and/or Sclera
pictograms and/or other images or photo’s, with option
to navigate between the pages. These pages can still be
adjusted based on preference of the users.
Step 4, PID learned to use AbleChat: This was done by
their own caregivers. The caregiver could count on
online support. The research team went on site at the
request of the caregivers. Caregivers were advised to
take sufficient time to learn to use the app and to create
opportunities to communicate with the AbleChat
(receive, send, reply messages).
2) Evaluation of the AbleChat app after pilot 1
At the end of the first pilot , both the caregivers and users
were asked to evaluate the AbleChat app. Caregivers were
asked to fill in a questionnaire based on the “App Evaluation
Rubric” from Pei-Lin Weng and Teresa Taber-Doughty [11].
Users were asked about their findings through a semi-
structured interview that determined their experiences and their
findings about the app.
a) Evaluation by the users
Users were asked about their experiences with and their
findings about the app through a semi-structured interview.
The following questions were asked: Do you still use the
AbleChat app? When, what for, how often? What do you
like/not like about AbleChat? To whom do you send/would
you like to send messages? Can you use the smartphone well?
Do you want to continue the use of AbleChat?
The users of the app, use AbleChat more than once a week,
some of them even every day. They say they mainly use the
app for messages related to work, related to the organization in
which they stay or related to independent traveling. They now
communicate with their caregiver, but they would also like to
send messages to other caregivers and to their friends and
All users demonstrated that they are able to send and read
messages independently with the AbleChat app. They all want
to continue using the app.
b) Evaluation by the caregivers
The AbleChat app makes it possible for people with IDD
who cannot read or write to send and read messages. This
increases their independence, self-confidence and safety. That
is why, for all caregivers and users, the AbleChat app has an
important value. The strength of the app is that it is
individually adaptable.
Although it is not easy to communicate by using only
pictograms, all caregivers say that it is certainly possible, if the
meaning of the pictograms is clearly agreed on with the user.
Individual ‘pictogram language’ is possible, which makes the
content of the app appropriate for all users.
The quality of the design of the app in caregiver mode is
generally scored well. Caregivers find the app simple, clear and
easy to navigate. Caregivers want to be notified when their
message is sent and read or when an error has occurred. They
want a notification of the time a messages is sent by the user as
The quality of the design of the app in client mode is scored
moderate. The layout is not yet simple and clear enough and
the app is not yet easy enough to navigate. Nowadays, the user
must take too many steps to send or read a message. For a lot
of users, the steps that have to be made to send or read a
message are complicated and complex. The caregivers made
some suggestions to improve the lay out. But all the actual
users manage to send and read messages independently.
The quality of the design of the website is scored variably.
At first sight, most caregivers find the website not userfriendly
because of the layout and the language that is used (English),
but after some training most of them can use the website
independently. Nevertheless, a more simple layout and
operation are preferred. According to most of the caregivers,
possible actions of the app should be offered on the website as
options instead of standard settings.
Caregivers say that the researchers are responsive and
helpful. They help them quickly with any problem or question
they experience and give clear and accurate information.
Caregivers know that, at any time, they can contact the
researchers and they do so.
The use of the app and the smartphone requires many skills
of the user. Yet it is achievable for them to use the smartphone
and the app, though it must be practiced enough. This aspect
should definitely be taken into account when one wants to start
using AbleChat.
G. Next steps
Based on above findings, the final AbleChat app will be
designed. This third design solution will be tested and
evaluated in a second pilot round.
1) Third design solution
During the development of the final version a few new
functions will be integrated and a few functions will be either
adapted or improved.
Code refactoring of organizations to network of the
client will happen to enable the client to chat with
friends or family members and with individual
caregivers. This has the result that also an address book
or list with contact people should be provided.
Contact people will be listed in a vertical list with icon
and name. The immediate phone key to the coach will
be removed. It is assumed that clients who can work
with a list of contact people can also consult a list of
contact people on the smartphone. Those clients for
whom this is too difficult, an immediate phone key with
picture can be placed on the desktop of the smartphone.
Lay out will be simplified for the user. A clear (visual)
notification will appear on the screen when a message is
received, even if the app is closed down.
It will be researched whether the signal for received
messages can be strengthened. There will be a visual
notification if a message is sent/read. The send key will
be visualized with a standard logo.
It will be attempted to decrease the number of actions
needed to send/receive messages.
Keyboards will be able to open up and cover the whole
screen with the results the keys will be bigger and the
pictograms will be clearer.
There will be a timestamp added for the caregiver so he
can see when a message was sent.
Caregivers can see what users are doing: not using the
app, viewing the list, viewing chat, typing message.
It will be possible to remove excess pages and keys
through the website. There will be less jargon on the
website. It will be researched if scaling or cropping of
pictures can be built in thus enabling all pictures to be
visible on the smartphone.
A visual indicator for unread messages is added.
The installation of the app will happen through play
2) Technical details
The majority of input we received from the caretakers was
related to either user friendliness or user experience of the
website. Caretakers commented that the website placed to
much emphasis on the 'business' aspect of the application. They
felt this created a disconnect between the users and their
environment, focusing too much on managing an organisation.
Though conceptually similar it was decided to replace the
concept of organisations and admins by a network of people
that surrounds each individual user. Caretakers can still have
different roles within this network without the need for a
formal organisation.
Removing the concept of organisations does add a few
difficulties. Users used to be tied to one organisation, allowing
for relations to be created between them in a safe way. This no
longer applies when users are no longer part of a larger whole.
Creating relations between them so they can communicate with
other users now becomes more complex regarding privacy as it
requires some form of identification. Simply providing a search
function is out of the question as this would enable querying
the entire database. This might only give an attacker insight in
who is using the application, but it is still information we do
not want to provide. Instead every user now has an
alphanumeric code to identify them. Using this code as a QR
code enables users to simply scan their friends phone and lets
them build their network themselves.
The smartphone application will be overhauled as well,
though focusing mostly on layout. The technical aspect is quite
sound, but the layout and presentation were found to be
cumbersome to use.
3) Second pilot round
The second pilot will be conducted during 4 consecutive
This will require a close collaboration with the caregivers
and organizations involved. Firstly, PID and their caregivers
should be well informed and well trained in the use of the new
Mobile phone app. Secondly, the caregiver and the user need to
make a contact list. It is important that PID can communicate
with multiple caregivers and with friends and family.
Subsequently, the persons on that contact list need to get
familiar with the use of AbleChat. For this purpose, an expert
for each of the organizations will be trained. This person will
train other caregivers, users and their family. Finally, the users
should get the opportunity to use the AbleChat app as much as
Besides testing the usability of the app, this study will also
examine to what extent the use of AbleChat can contribute to
the Quality of Life of PID [13] [14].
As a general concept, when involving users with
intellectual disabilities in the design process, it’s been
designated to make the circumstances as realistic as possible.
Beginning by exploring the context of use, it was possible
to develop a first prototype that comes as close as possible to
the requirements set out at the start. The evaluation of this first
design by the caregivers who know the needs of the client
group very well, resulted in concrete tips that lead to the
second design solution. The second design solution was again a
prototype, this time with the purpose of being evaluated by the
end-users, PID. The observation of the end-users while they
were testing AbleChat delivered the necessary information to
both evaluate the app and the use of it by the PID. The divers
group of users (age, sex) in diverse contexts (6 different
organisations) delivered valuable information on the strengths
and weaknesses of the application.
Both the PID and their caregivers are excited about the
concept of sending messages using pictograms. The prototype
has the restriction that PID can only chat with their caregivers.
There is a desire to extend the application and allow sending
messages to friends and relatives. This requires a redesign of
the app, as the option must be created to have an individual
chat with one or several people. Caregivers should cooperate
with the users, think carefully about the pictograms that are
available and on how to navigate those. The users must have
easy access to the key pictograms. They need appropriate and
adequate pictograms to respond to the received messages from
Because it is difficult for the users to formulate their needs
and expectations, it is important to observe the use of the app
on large scale and in different contexts. Through the follow up
study we want to get insight on effectiveness, efficiency,
satisfaction, understandability, intelligibility, operability or
supportiveness, flexibility and attractiveness of the app. This
will take place through participative observations and
interviews with caregivers and users.
The caregivers will be asked to fill in another App
Evaluation Rubric questionnaire. Lastly, we will examine if
and how the app can contribute to the QOL of people with an
intellectual disability.
In the framework of the Able-to-include project the
Accessibility Layer will be evaluated as well: does the
translation of the pictograms meet with the expectations? For
this a collaboration with the project partner KU Leuven will be
set up.
Including the stakeholders from the start of the
development asks for a large engagement, effort and time
investment of both the caregivers and the users. Caregivers
have to make time to learn the use of the app and of the
website, to create accounts, to teach the use of the app to the
users, to adjust the account with extra pictograms and
navigation, and to create opportunities for the users to
effectively use the app. In addition the caregivers have to spend
time in meetings, evaluation and administration. Furthermore
we need to take in account the fact that caregivers are not
always familiar with the use of technology such as smartphone
and computers, and certainly not in the context of use by PID.
If technological developments can contribute to the QOL
for PID, these people should get the opportunity to get to know
these applications and to learn to use them. To accomplish this,
the necessity is there to ensure there is enough time and
resources to train both caregivers and the user.
In the framework of ongoing EU project ’Community
Service Engineering’ the mobile application ’Travel and
Communication Assistant’ with adaptive user interface is
developed which supports the mobility and communication of
PID. This research involves staff, PhD, bachelor and master
students at Thomas More University, Geel, Belgium and
Software Engineering Department at Volgograd State
Technical University, Volgograd, Russia. The main advantages
of the application are: rich functionality to provide the support
of mobility and communication of PID; adaptive dynamic
interface for users with ID; cross-platform implementation.
The adaptive user interface for different ways of contacting
a PID with a caregiver depending on the capacities of the
person is designed and implemented. It includes the following
components: pictogram menu for choosing the sending mode;
menu of pictogram categories for creating pictogram messages;
set of test messages; hot buttons. The interface for user with ID
can be adapted to the user by two following ways: caregiver
can adapt the interface manually using the interface settings;
caregiver can use an automated interface adaptation on the base
of statistical analysis of user behavior.
’Travel and Communication Assistant’ is implemented as a
cross-platform client-server application using Unity3d, C# and
Google Maps API for the client part, PHP, MySql and XMPP
for the server part, services Text2Picto for translation of text to
pictogram message, and data bases of pictogram Sclera, Beta
and PECS.
The application is developed in close cooperation with staff
and pupils of Volgograd Regional Rehabilitation Center for
children with disabilities ’Nadezhda’ who have been involved
throughout design, development, evaluation of design solutions
and testing the application. In the nearest future it is planned to
implement the real-time interface adaptation that allows
adapting the interface during interaction process, and to test the
developed application on the target groups of PID and their
caregivers in Belgium and Russia.
We thank all the organisations, users, caregivers who
participated in the development of AbleChat. This co-creation
has given K-point the possibility to expand on the knowledge
and expertise on technology for PID.
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... A participatory, user-centered, inclusive, or humancentered design methodology was used in several studies, to enable collaboration with people with communication disabilities (Daems et al., 2016;Hervás et al., 2020;Lundälv et al., 2014;Mertl & Frič, 2019). Qualitative, descriptive methods were used in more than half of included studies (n = 13). ...
... Qualitative, descriptive methods were used in more than half of included studies (n = 13). Seven studies included further details about methods, including the use of participant observation, interviews, questionnaires, prototype development, and user testing methods were typically used to determine AAC user needs, inform development, and evaluate AAC systems (Daems et al., 2016;Deliege, 1989;de Oliveira et al., 2016;Heikkilä et al., 2019;Huertás & Nohama, 2014;Lundälv et al., 2014;Mertl & Frič, 2019). Content analysis and descriptive statistics were used to analyze data in one study (Mertl & Frič, 2019). ...
... People with disabilities and/or who use AAC were involved in just over half of the studies as participants (n = 13). Caregivers and people without disabilities were also included in several studies (Daems et al., 2016;Iida & Campbell, 2003;Nakazono et al., 2010). Other studies recruited participants without disabilities, including health, allied health and linguistics students and professionals, special education teachers, or native adult speakers of the study language (de Oliveira et al., 2016;Heikkilä et al., 2019;Hervás et al., 2020;Johnson et al., 2006). ...
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... These resources and research activities enabled participants to engage in the research, feel confident and connected to their culture, and share their opinions through stories. Other studies in AAC development in non-English languages have also used PAR (e.g., Draffan et al., 2015), user-centered design (Herv as et al., 2020), or human-centered design (Daems et al., 2016). Collaborative and user-centered design approaches ensure AAC systems are usable and useful, whereas PAR also aims to challenge existing power dynamics. ...
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