Depth of Knowledge 1

Intellectual and developmental disabilities (IDD) negatively impact an

individual’s adaptive behaviors (Woolf et al., 2010). These behaviors are a set of

skills that allow people to participate autonomously and with minimal interpersonal

conflict in their daily lives. Traditionally, in a post-institutionalist society, parents of

people with IDD have taken care of their children into adulthood. Advancements in

healthcare for people with IDD has resulted in increasing lifespans (Hodapp et al.,

2016). With this development, adults with IDD are out-aging their parents’ ability

to act as caregivers due to their own aging-related limitations. This has resulted in

solutions that are predominantly centered around continued direct support by other

family members or paid support professionals.

In order to promote greater skills in areas of independent living for people

with IDD, many strategies exist, such as prompting, breaking down steps into

smaller steps, and scheduling (DiStefano et al., 2020). Many of the common

strategies are highly dependent on direct support from a person. This type of

intervention is limiting in a few ways. Learned helplessness, direct support

professional turnover, or the barriers inherent to direct support in social

engagement are examples of potential limitations to traditional interventions.

Technology advancements offer an opportunity to address these limitations in

development of future interventions and supports.

Technology as a support tool

Technology by definition is a tool to support people in accomplishing a task.

This applies equally to people with disabilities as to people without disabilities. As

new technologies emerge, they are designed specifically for people without

disabilities, often completely ignoring those with disabilities as end users. This
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overlook in design means that emerging technologies must be examined, adapted,

and tested as benefits to people with disabilities. Ideally this would be done while

the technology is being designed prior to its public release through the process of

universal design (UD). UD is a paradigm of design in which the products and

environments are specifically designed with a diverse set of end users in mind in

contrast to the designing for the average user (Burgstahler & Cory, 2008). Use of

commonly used devices instead of dedicated devices designed specifically for a

person with a disability is usually preferred (Faucett et al., 2017). Two potential

emerging technologies that offer promise and are ready for exploration are virtual

reality (VR) and wearable technology.

Virtual reality

As the price point and size for VR equipment has become more commercially

viable, theoretical discussions of the applications in education have occurred (de

Oliveira Malaquias and Malaquias, 2016). Researchers have explored several

possible uses for people with IDD. The uses to this point have tended to center on

just a few areas of needs; travel or pathfinding and job skills. For the purposes of

this exploration, I will examine the use of VR for teaching travel skills.

Travel

In Shopland et al. (2002), the authors describe a project to design a non-

immersive VR for travel training in a specific British city. They used a user-centered

design in which representatives of the intended end users provided ideas for the

design prior to implementation and then evaluated the usability and effectiveness of

the design after. The design included a focus of realism by including important

landmarks for wayfinding.

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Similarly, in Farren et al. (2012), the effectiveness of landmarks in learning a

virtual route for people with Williams syndrome in comparison to people with typical

development. However, the designed virtual environments had no real-world model

and were instead a set of brick mazes navigated by mouse and keyboard. People

with Williams syndrome were able to learn the correct path though they took more

time in the learning phase and made more errors.

In a different, but related vein of study, Courbois et al. (2013) examined the

wayfinding and shortcut finding abilities in a group of young adults with Down

syndrome and compared to control groups of people with typical development

where one group was controlled by chronological age and the other by

developmental age. Similarly to Farren et al. (2012), the virtual environment in the

study was a fictitious city neighborhood of a three-by-three street grid. The study

indicated that people with Down syndrome can learn landmarks and routes, but

may need more trials until mastery than both their chronological and

developmental age counterparts.

Wearable technology

Wearable technology has become increasingly more popular over the last

decade. It has become commonplace for daily wear of at least one item of wearable

technology with one of the most common examples being the smartwatch. This

commonplace wear makes for an ideal item as an assistive technology device as it

does not draw unwanted attention to the user as some more specific dedicated

devices would. A majority of the past research has focused on the fitness tracking

abilities of such devices which makes sense with some of the earliest examples of

wearable technology being pedometers. More recently explorations into uses as a

 Depth of Knowledge 4

device for prompting and self-regulation or monitoring. Many studies have

combined both of these functions to varying degrees. For the purpose of this paper,

I will focus on the prompting use.

Prompting

In Jamieson et al. (2016), the authors explored the use of smartwatch

prompting for completion of daily tasks that were often missed due to memory

issues. In the study, only a short training and a manual for the technology was

provided to the participants. The training concerned the functions of the watch

necessary for participation. The results indicated marginal, non-significant increases

in ability from baseline, but a significant decline upon withdrawal was observed.

In contrast, Maich et al. (2019) used a mixed method pilot study to examine

the use of mobile technology as a support tool for adults with IDD where the

nonintervention data collected through interviews was of the most value. A majority

of the participants focused on a mixture of budgeting and time management as

targets of the intervention. The devices and apps were taught to the participants by

support staff using Natural Environment Teaching. The qualitative data is of

particular interest. The participants and their support staff indicated a strong impact

of preferences about technology and customization for adaption of the technology.

It was also noted that motivation to learn a new technology or application was a

strong indicator of continued use.

In another study concerning the use of mainstream apps and connected

wearable technology, Baker et al. (2019) examined the ability to learn and utilize

smartwatches and connected applications to manage time by college students with

IDD. All three participants made a significant jump from zero or nearly zero correct
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completions of a 26-step process during the baseline to an average of 24 correct

steps during intervention. Additionally, there was a marked improvement on leaving

for the scheduled activity when the alarms on the watch indicated. Beyond

participation in the study, the participants' only other input into the process was a

simple agree or disagree social validity survey with five questions.

Divergent from the previous studies in wearable technology, Evmenova et al.

(2019) used a mixed methods approach that focused much more on input of the

intended end user within a design-based research framework. The researchers

explored the support needs of young adults with IDD in postsecondary courses and

the design principles needed in a wearable technology solution to meet those

needs. The participants were both support staff and young adults with IDD who

both had opportunities throughout the study to contribute to the design of the

intervention technology. Through interviews, it was noted that the technology

would be a valuable tool to provide physical distance between staff and students,

would need to be accessible to many different literacy levels, and offer quick ability

to provide feedback and communication between staff and students.

Gaps in the Literature

There are improvements to be made in the ethics, methodology, and

theoretical gaps in the research concerning the use of technology for people with

IDD. One major ethical concern derives from the nature of the abilities of the

technology used. Modern technology devices often have many features that may or

may not be the primary feature being utilized by the user. For example, a person

may use a wearable technology device primarily as a fitness tracker and prompting

device, but many such devices have location tracking abilities. If a user is unaware
 Depth of Knowledge 6

of the feature or who else has the ability to access the collected data, many privacy

concerns exist. In the studies referenced above, device training for the participants

was limited to the features being utilized for the study. It would be more prudent to

teach the participant the full functionality of the device they are utilizing, as well as

any potential risks or other security concerns prior to consenting to using the

device.

Methodological and theoretical concerns are similar to other studies of people

with IDD. The research in the field of special education has traditionally been

conducted with people with disabilities as test subjects. The goals of the research

have been to pursue evidence-based interventions of problems identified by either

members of the academy or so-called “key stakeholders”. In the literature, these

key stakeholders are often parents, other family members, or support people, such

as teachers or personal care attendants. This approach has an unfortunate and

unintended outcome of diminishing the autonomy of people with IDD through

reducing the power of their input into research and, as a byproduct of this

exclusion, policy.

Addressing the Gaps

I feel like I have a unique combination of knowledge in accessible and

assistive technology and an ability to make strong and trusting relationships with

people with IDD that affords a different approach to past research in the use of

technological interventions with people with IDD. These past approaches have been

largely quantitative in nature which provides good evidence of effectiveness, but

without a more personal examination of the intervention through conversation a

complete picture concerning acquisition, adoption, and utility is unobtainable. This

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is especially true with the design of such technological tools being done by someone

who themselves is not a person with IDD. The principles of UD in a perfect world

would help alleviate these concerns. In practice, however, UD is only as good as its

utilization. All members of the population must have a representative voice

informing the design process to address the unique concerns of particular profiles.
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Baker, J., Wennerlind, R., Devine, S., & Nasir-Tucktuck, M. (2019). The Use of

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Burgstahler, S., & Cory, R. (Eds.). (2008). Universal design in higher education:

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