Adapting assistive technology for different cultures
Communication Concerns
Communication: The interaction between two or more individuals in order to construct understanding[i]. It includes verbal, nonverbal (physical), written, and interpersonal communication. The sub-topics are:
Language
Cognition
Communication Style
An assistive technology designer will need to communicate with a user for a variety of reasons, such as
advertising
product information
training or instruction on proper use
communication embedded within the device, such as a mobile app.
The amount of communication needed can vary. For example, a bathtub grab bar likely has no text associated with it, other than perhaps installation instructions. Some devices like scooters may have limited text and symbols (to indicate the speed selected and to advise users not to get the device wet). Other devices, like health apps and robots used to facilitate communication, are primarily language-based.
Attitudes and user compliance can also be affected by implicit communication. Designers should think about what message they are sending to their intended audience. Are people treated as if they are broken and only the new technology can fix them? How would that affect the potential use of the technology?
Click on the following buttons to view the cultural adaptation questions and examples for each sub-topic.
Language
Question
General Example
Self-Feeding Device
Glucose Monitoring App
How can potentially negative or offensive word choices be identified in the new cultural context?
Written material (advertising/ instructions) that includes words such as “fat” or “handicapped” may have different connotations depending on the audience.
The user’s manual refers to people “living with disability” rather than “handicapped” people, in order to put the person first and avoid stereotypes. Person-first language may or may not be appropriate for specific conditions or cultures, so the designer will need to research.
The Glucose Companion app tracks users’ weight along with their sugar readings, which may make users feel as if they are being fat-shamed.
What process has been taken to ensure the accuracy and equivalence of the various translations?
Grammar and structure for all written and spoken aspects of the assistive technology must be at the level of a native speaker with limited formal education.
Grammar and structure for all written and spoken aspects of the AT must be at the level of a native speaker.
Grammar and structure for all written and spoken aspects of the assistive technology must be at the level of a native speaker.
How will dialectical differences be addressed appropriately?
Word usage may vary across speakers of a common language, like “trunk” in the U.S. vs. “boot” in the U.K., so written information may need to be adapted even within a single language.
N/A
Many mealtime words are used in the U.K. that aren’t typically used in the U.S. at all, such as “pudding” referring to dessert itself. The U.S. exclusively uses “pudding” to mean a custard-style dessert . The word “tea” refers to the main evening meal in northern regions of the U.K., but regions in the south use the term “dinner” instead. Differences in mealtime words may cause confusion across cultures.
Cognition
Question
Example
Self-Feeding Device
Glucose Monitoring App
What level of comprehension is required to use the assistive technology?
A user must be able to read and comprehend written directions, and understand all vocabulary used in spoken directions. Mental disabilities may affect the user’s ability to understand directions or remember commands.
A person may be able to sound out words in written directions without actually understanding what they mean.
The app must be designed with a literacy level that is representative of the intended user.
What other ways can necessary information be represented?
Some people may find it easier to understand diagrams rather than text or learn best with a combination of the two. People with learning disabilities may prefer to have text recorded so they can listen instead of read, or have the option of a font style appropriate for dyslexia.
Diagrams, instructional videos, and drawings can offer alternatives or companions to written information.
A person may have difficulty understanding the number used in diabetes management. Blood sugar levels and weight levels could instead be represented by “red light, yellow light, green light” to indicate acceptable readings.
How will the education or training level of the user affect the functionality of the assistive technology? What previous knowledge would be expected of the user?
The user may need to be both literate and computer literate, with the assistive technology’s reading level appropriate for the user. Health literacy levels may also vary across cultures, education levels, and socioeconomic status.
The user’s manual for the OBI device is written between an 8th and 11th-grade reading level, according to the SMOG Index and the Linsear Write Formula. Users who have a lower English reading level may have difficulty reading important information.
The user would need to know how to use a smartphone or tablet, understand graphs and tables, and comprehend language choices, such as “glucose reading” instead of “sugar level”.
Communication Style
Question
Example
Self-Feeding Device
Glucose Monitoring App
Which manner of communication is the most appropriate for each audience? Is it direct or gentle? How does age or social status impact communication methods?
In Asian and Middle Eastern countries, the style of communication is largely dictated by the closeness of the relationship between two people and the tendency to place a lot of meaning onto nonverbal clues. In North America, most communication is direct and open and often does not change because of status or age. The designer will need to assess the target populations’ preferences.
In some cultures, a high-status person is automatically given implied authority. In other cultures, the elder person (either the user or the therapist) would be in charge. The therapist’s tone and language may need to adapt depending on the client as they help the client learn how to use the OBI .
An app that offers written praise like “Great job!” for glucose readings in the normal range could be viewed as encouraging and motivating. Some users may prefer that the app sends the data to their doctor so the doctor can guide them, either over the phone or in person. In addition, older adults may be less comfortable with app-based technology, although that is changing rapidly.
What is the user’s preferred method of communication?
Some cultures use oral communication, preferably in person, which means someone would need to be available to explain the assistive technology. Others would prefer a written manual that they can refer to as needed. Also consider that user may have a learning disability, which would affect their communication style.
A user may need to have access to a common language speaker who can address ongoing questions and concerns about the device.
The user may or may not be able to understand the app and use it without a formal introduction. If a professional is required, there may be a preference for an in-person meeting or electronic communication. Any communication between the user and care providers done through the app must be done in the method of communication most likely to be preferred by BOTH the user and care provider.
How have designers consulted end users as part of the assistive technology development process?
End users should be consulted throughout the process, from defining a problem to beta testing .
End users may be involved to design features they want to have, the range of the robot arm, adaptations for the selection tools, etc.
Designers can test app features and functionality with a focus group of individuals with diabetes and compare them to individuals managing diabetes without an app.
What kinds of nonverbal communication (such as body language) will affect the comfort level of the user?
Eye contact, volume and speed of speech, and listening to responses can make some cultures, like First Nations people, feel comfortable and encourage adoption of a technology.
A caregiver setting up the OBI device should be aware of the user’s preferences regarding familiarity, proximity, touching, etc.
