"It Is Easy Using My Apps:" Understanding Technology Use and Needs of Adults with Down Syndrome

TL;DR

This paper addresses the gap in understanding how adults with Down syndrome use technology and what they need from assistive tech. Using semi-structured, dyadic interviews with six adults with DS, seven parents, and three experts, the study employs Reflexive Thematic Analysis to derive four DS-centered design themes: community versus home social involvement, misalignment of skill expectations, family limitations in technology support, and considerations for technology development. The findings reveal nuanced preferences for privacy, variable views on speech and literacy supports, and the central role of families in early adoption, followed by independent use, informing four concrete design implications: positive reinforcement, multimodal interactions, clear instructional visuals, and adaptable privacy features. These insights advance DS-specific adult-oriented assistive technology design, offering actionable guidance for developers and policymakers to enhance independence, safety, and social inclusion for adults with DS.

Abstract

Assistive technologies for adults with Down syndrome (DS) need designs tailored to their specific technology requirements. While prior research has explored technology design for individuals with intellectual disabilities, little is understood about the needs and expectations of adults with DS. Assistive technologies should leverage the abilities and interests of the population, while incorporating age- and context-considerate content. In this work, we interviewed six adults with DS, seven parents of adults with DS, and three experts in speech-language pathology, special education, and occupational therapy to determine how technology could support adults with DS. In our thematic analysis, four main themes emerged, including (1) community vs. home social involvement; (2) misalignment of skill expectations between adults with DS and parents; (3) family limitations in technology support; and (4) considerations for technology development. Our findings extend prior literature by including the voices of adults with DS in how and when they use technology.

Figures (3)

• Figure 1: Interview study design. During the first phase of interviews, adults with DS (shown in the middle row in blue with IDs starting with A) were paired with one of their parents (shown in the top row in dark blue with IDs starting with P). Parent participant P4 was interviewed alone. The gray people in the bottom row indicate which pairs included a third person not directly interviewed in the interview session. The three expert interviews (shown in yellow with IDs starting with E) were completed during the second phase of interviews. The initial findings from the first phase of interviews informed the second phase of interviews.
• Figure 2: Four main themes found though data analysis, with three sub-themes each. The two blue columns outline technology usage through lived experience. The two yellow columns outline what to consider when designing and developing assistive technologies for adults with DS. Theme 1: Community vs. Home Social Involvement, 1.1: Speech and Language Support for Social Involvement, 1.2: Privacy Within Family, 1.3: Community Social Activity Involvement. Theme 2: Misalignment of Skill Expectations Between Adults with DS and Parents, 2.1: Verbal Communication Breakdowns, 2.2: Written Communication Expectations, 2.3: Skill Regression During Life Changes. Theme 3: Family Limitations in Technology Support, 3.1: Family Technology Apprehension, 3.2: Family Investment Assisting Technology Adoption, 3.3: Barriers in Accessing Technology. Theme 4: Considerations for Technology Development, 4.1: Customizability and Simplicity, 4.2: Age Considerate Content, 4.3 Physical Elements and Visual Representation.
• Figure 3: Design implications derived from the four themes outlined in Section \ref{['sec:results']}. Each suggestion contains color coding that connects them back to the themes they were derived from. The color key indicates which color is related to which theme, using the same color scheme as Figure \ref{['figure:2']}. The four implications consist of the following: (1) positive reinforcement and ability recognition; (2) multimodal interactions; (3) clear visual instructions for adults with DS and caregivers; and (4) caregiver inclusion and privacy concerns