Chapter 1: Digital assistive technologies (DigAT)

What are assistive technologies?

There is no consensus definition of assistive technology. According to the World Health Organization (WHO), assistive technology is an umbrella term for assistive products and their related systems and services which help maintain or improve an individual’s functioning related to cognition; communication; hearing; mobility; self-care; and vision (footnote 42) . The International Standards Organization has defined the term ‘assistive product’ as devices, equipment, instruments and software used by or for disabled people for participation; protection, support, training, or substitution of body functions and activities; or prevention of impairments and activity limitations (footnote 43).

The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) provides the following definition of assistive technology:

“Products or systems that support and help individuals with disabilities, restricted mobility or other impairments to perform functions that might otherwise be difficult or impossible. These devices support individuals to improve or maintain their daily quality of life by easing or compensating for an injury or disability (footnote 44).”

The Assistive Technology Industry Association defines assistive technology as ‘any item, piece of equipment, software program, or product system that is used to increase, maintain, or improve the functional capabilities of persons with disabilities’ (footnote 45). The Business Disability Forum defines it more simply as ‘technology designed primarily to be used by disabled people’ (footnote 46).

Assistive technologies include analogue products which may not be commonly described as ‘technology’ (ie digital technology). Examples include manual wheelchairs, hearing aids, crutches and communication aids. They can also be broadly classified into no-tech, low-tech, and high-tech categories (footnote 47) as displayed in Table 1.

Table 1

Classification of assistive technologies

The World Intellectual Property Organization (WIPO) defines assistive technologies as either ‘conventional’ or ‘emerging’ across the domains of hearing; cognition; mobility; self-care; built-environment; vision; and communication. Examples listed of conventional assistive technologies include alarms; timers; induction loops; prostheses; adaptive clothing; and glasses. For emerging assistive technologies, examples include smart home devices; assistive robots; navigation aids; automated lip reading; exoskeletons; health monitoring wearables; and augmented reality devices (footnote 48).

Data from WIPO suggests there are more than 3,000 unique sub-categories of conventional assistive technology. For emerging assistive technologies, there are 180 unique sub-categories. In total, there are approximately 117,000 patent filings for conventional assistive technologies and more than 15,000 for emerging assistive technologies (footnote 49).

What are digital assistive technologies?

As with ‘assistive technology’, there is no consensus term for ‘digital assistive technology’ (DigAT). For the purposes of this report, a definition of DigAT was co-formulated with disabled people as part of focus groups conducted by the Research Institute for Disabled Consumers (RiDC) (footnote 50). A broad definition was preferred, encompassing both mainstream technology (containing assistive functions) and technology specifically designed for disabled people. The definition adopted was ‘any digital technology that processes information to help make your life easier’. Survey participants in the RiDC research were provided with the definition and additional context as follows:

“Any digital technology that processes information to help make your life easier. This can include screen-readers, speech-to-text software, or applications which support daily living such as Grammarly, NaviLens, or Be My Eyes. It does not include non-digital assistive aids like canes, wheelchairs, or magnifying glasses.”

Similar to conventional assistive technologies, examples of DigAT can be found across many domains and be used by a diverse range of disabled people. The case studies in this report contain examples of DigAT applied for employment, gaming, tourism, music and social care.

These include video conferencing platforms with automated captions; adaptive gaming controllers; virtual reality travel simulators; live Braille translations for music composition; and smart home devices for social care. Using the seven WIPO domains for disability, Table 2 provides examples of DigAT and the user requirements they can help address.

Table 2

Classification of DigAT by user requirements

An evidence review conducted by the RiDC for this report (footnote 51) identified the following four major categories of DigAT, mapped against access barriers (eg cost, usability) and social presence barriers (eg availability, publicity):

• State of the art
  These are difficult to access but have a high social presence (eg Ray-Ban Meta Glasses). This may be due to their cost or complexity of use. Their social presence is high due to publicity and marketing around new innovations.
• Everyday technology
  These are likely to have a secondary assistive function whilst their primary function is more general. They are easy to access and have a high social presence. They can include smartphones, laptops and voice assistants which are used by most people in society daily.
• Outdated technology
  These may be used due to the user’s familiarity with the product and difficulty in adopting new technologies. However, these technologies may no longer be supported by the manufacturer (eg through software updates) and may be incompatible with new applications (eg new web browsers). The devices are, therefore, difficult to access and have low social presence (as they are old products).
• Medical devices
  These devices have been categorised as easy to access in a UK context due to potential availability via the National Health Service. However, they have low social presence as it can be difficult to find information about the newest technologies and how to access them.

These classifications can be used to complement the broad definition of DigAT to determine specific applications as well as factors which may affect their uptake or continued use.

Figure 1

Barrier-based classification of digital assistive technologies (DigAT)

Types of DigAT used by disabled people

Based on a UK-based survey of disabled people (footnote 52), in which participants were asked to list up to ten examples they use, DigAT can be grouped into the following four categories:

• Mainstream technology
  This refers to smartphones; laptops; tablets; desktop computers; voice assistants; and communication applications. Examples provided by survey respondents included in-built accessibility features such as screen-readers; dark mode; screen magnifiers; font or colour adjustments; and device-enabled captions. Others included voice-controlled assistants (eg Siri, Google Assistant, Amazon Alexa) and video calling applications.
• Task-specific technology
  This refers to technology aimed at performing specific tasks such as managing home appliances; travelling; seeking entertainment; and ordering food. Examples provided by survey respondents included app-controlled smart heating, lighting and switches, as well as wayfinding apps (eg Google Maps, Microsoft Soundscape) and entertainment-related apps (eg e-readers, gaming software).
• Barrier-specific technology
  This refers to technology aimed at addressing specific barriers in an individual’s environment. Examples provided by survey respondents included aids to access visual information (eg Be My Eyes, NaviLens, Seeing AI). Others included text-to-speech and speech-to-text software (eg Natural Reader, Dragon); apps to support with reading, writing, or composition (eg Grammarly); and apps to support organisation (eg calendar or task management apps).
• Health-tracking technology
  This refers to applications, software, or devices which track or manage health conditions, energy levels, or physical and mental symptoms. Examples provided by survey respondents included apps or devices to monitor bodily functions and movements; apps to manage medical appointments or prescriptions; and apps to support mental health.

Attitudes towards DigAT adoption

People can require assistive technologies throughout their lives, either temporarily due to illness or injury, or on a long-term basis because of ageing, chronic health conditions, or disability. As a common aspect of the human experience, the development of DigAT is relevant to everyone.

To explore attitudes towards DigAT adoption, two surveys of UK-based participants were undertaken for this report. The first, conducted by YouGov, surveyed a representative panel of approximately 2,000 members of the public (age 18+) (footnote 53). The second, conducted by the RiDC, surveyed a panel of 850 disabled people. The methodology for these can be viewed in Appendix 3.

According to the YouGov survey, people use technology for various routine daily tasks including staying in touch with friends and family (87%), purchasing goods (85%) and managing finances (78%). Almost half (47%) of 18- to 24-year-olds said they use DigAT, which were described in the survey as ‘support tools (such as speech recognition, adaptive keyboards, or magnification tools)’. This was the highest prevalence of the age groups as displayed in figure 2.

Considering the future, the majority (61%) are confident that technologies will meet their needs as they grow older and 67% are confident that they will be able to adapt to future technological changes. Confidence in their ability to adapt was significantly higher amongst 18- to 24-year-olds (76%) compared with those aged 55 and older (56%). Finally, almost three-quarters (74%) said they would be willing to adopt new technologies if they were shown to enhance their independence or access to services.

In the RiDC survey of disabled people, 62% said they use DigAT with more than half doing so throughout their day. Those with visual impairments were most likely to use DigAT throughout their day, with 44% of this group selecting this option. By age, 18- to 39-year-olds were most likely to use DigAT throughout their day. Over half of DigAT users (53%) said that without it, they could not live the way they did or that their daily life would be significantly more difficult. Of those who did not use DigAT, over half (55%) said they did not need to use DigAT for their access needs, while 19% felt they do not know enough or feel confident enough to use it. 58% said they would adopt DigAT if they knew what types were on the market, while 36% said they would adopt them if training was available to show them how to do so.

Figure 2

Frequency of using support tools to perform digital tasks

Survey results for the question: How often, if at all, do you use support tools to perform routine digital tasks on your own (such as speech recognition, adaptive keyboards, or magnification tools?

Case study 1: DigAT for the world of work

According to the Organisation for Economic Co-operation and Development (OECD), there is a persistent disability employment gap with disabled people 2.3 times more likely to be unemployed than non-disabled people in 2019 (footnote 54). In the UK, at the time of writing, the disability employment gap stands at 28.6 percentage points, with only 53% of disabled people employed (footnote 55). While work may not be appropriate for all disabled people, many unemployed disabled people want to work and employment can reduce inequalities.

Opportunities

Remote work has long been practiced by disabled communities and the flexibility of remote work has positive impacts on disabled workers’ productivity and health. In a recent survey, 70% of disabled workers said lack of access to remote work would negatively impact their health (footnote 56). People with mobility limitations can avoid commuting, which may be more difficult or expensive. People with fluctuating conditions, such as chronic fatigue or conditions requiring medical equipment, benefit from more control of their work schedule and environments to better manage their disabilities (footnote 57). Video communication software, such as Microsoft Teams, can support remote working with features such as the ability to mute and control audio, video and interruptions especially useful for neurodivergent users (footnote 58).

Disabled people use other types of DigAT at work or for finding jobs. Surveys of blind or low vision people (B/LV) identify screen readers and smartphones as the most commonly used tools at work (footnote 59). Live transcription tools can also be useful for making meetings more accessible. Mainstream devices, such as smartphones, can be preferable to specialised technologies as they are multifunctional reducing the cost and maintenance of using multiple devices (footnote 60), which is especially useful for disabled workers in low-resource settings (footnote 61). For finding work, the chatbot Zammo.ai has been designed to provide users with a more accessible way to access information on job board platforms, such as LinkedIn, by using text or audio questions (footnote 62).

Challenges

The use of technology at work can produce barriers for disabled people. Disabled workers may struggle to afford DigAT with many disabled workers using their own money to purchase assistive technologies (footnote 63). Disabled people are almost three times more likely than non-disabled people to have no computer or internet at home, which is needed to access and use most DigAT (footnote 64). While remote work can have advantages for disabled people, there is a risk it could exacerbate the high social isolation levels disabled people report (footnote 65). For this reason, it is important that the use of DigAT for remote work does not remove the need to make physical workplaces more accessible.

Even when DigAT is available, it may still exclude disabled workers. Mainstream video communication platforms, such as Zoom, can have accessibility challenges such as lack of integration with screen readers and inaccessible user interfaces (footnote 66). Disabled people are also less likely to work in professional office-based jobs (footnote 67) where remote working is more available (footnote 68). A recent survey found one in five disabled workers requesting adjustments for remote working were refused (footnote 69).

Other challenges include lack of awareness and training, both for disabled employees who may not be aware of or need training to use DigAT and for colleagues and managers to foster a more inclusive accessible work culture.

Example: Riziki Source

Riziki Source is an online platform developed to address the disability employment gap in Kenya by linking disabled people with prospective employers. Through an app, users can create profiles to apply to jobs at employers who have training in implementing reasonable adjustments for disabled candidates. This reduces the risk of disabled people not being adequately supported in the workplace and ensures employers access a diverse group of candidates (footnote 70).

Conclusion

Supporting DigAT in the workplace can improve access to employment for disabled people and increase the representation of disabled people across organisations. Support and training for employers and employees will be required to ensure the implementation of DigAT does not inadvertently increase barriers for disabled people in the workplace.